MEDICARE: MR. STEPHEN ACEVES ORTHOTIST

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
1	332BC3200X	Customized Equipment (DME)	C17320	TX

General Provider Information

NPI Number	:	1588807929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN ACEVES ORTHOTIST

Provider Business Mailing Address
First Line	:	2655 HIDDEN RIDGE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-4013
Country	:	US
Telephone Number	:	817-469-1951
Fax Number	:	817-860-4472

Provider Business Practice Location Address
First Line	:	2655 HIDDEN RIDGE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-4013
Country	:	US
Telephone Number	:	817-469-1951
Fax Number	:	817-860-4472

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2009
Last Update Date	:	04/15/2009

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Directions to “ MR. STEPHEN ACEVES ORTHOTIST” Practice Location

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