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NPI Code Detail

MEDICARE: MEDICAL CENTER BRACE & LIMB, INC.

MEDICARE: MEDICAL CENTER BRACE & LIMB, INC.
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)000065TX

General Provider Information

NPI Number : 1255421137
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL CENTER BRACE & LIMB, INC.
Provider Business Mailing Address
First Line : 6560 FANNIN ST
Second Line : STE 280
City : HOUSTON
State : TX
Zip : 77030-2785
Country : US
Telephone Number : 713-795-0647
Fax Number : 713-795-0326
Provider Business Practice Location Address
First Line : 6560 FANNIN ST
Second Line : STE 280
City : HOUSTON
State : TX
Zip : 77030-2785
Country : US
Telephone Number : 713-795-0647
Fax Number : 713-795-0326
Authorized Official
Title or Position : PRESIDENT
Name : JOHN W. FAIN II
Credential : C.O./ CPO
Telephone Number : 713-799-1177
Provider Enumeration Date : 10/13/2006
Last Update Date : 08/22/2020

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