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NPI Code Detail

MEDICARE: FONDREN ORTHOPEDIC GROUP L.L.P.

MEDICARE: FONDREN ORTHOPEDIC GROUP L.L.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)179TX
2335E00000XProsthetic/Orthotic Supplier179TX

General Provider Information

NPI Number : 1164672374
Entity Type Code : Organization
Provider Name (Legal Business Name) : FONDREN ORTHOPEDIC GROUP L.L.P.
Provider Business Mailing Address
First Line : 7401 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-4509
Country : US
Telephone Number : 713-799-2300
Fax Number : 713-794-3395
Provider Business Practice Location Address
First Line : 2525 W BELLFORT AVE STE 150
Second Line :
City : HOUSTON
State : TX
Zip : 77054-5099
Country : US
Telephone Number : 713-349-9335
Fax Number : 713-349-8433
Authorized Official
Title or Position : COO
Name : KAREN YATES
Credential :
Telephone Number : 713-794-3339
Provider Enumeration Date : 09/24/2008
Last Update Date : 08/31/2020

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Directions to “FONDREN ORTHOPEDIC GROUP L.L.P. ” Practice Location

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