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NPI Code Detail

MEDICARE: MADELINE MAYA GOUGEON LICENSED ORTHOTIST

MEDICARE: MADELINE MAYA GOUGEON LICENSED 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
1222Z00000XOrthotist1995TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11995OTHERTXLICENSED ORTHOTIST

General Provider Information

NPI Number : 1669034831
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE MAYA GOUGEON LICENSED ORTHOTIST
Provider Business Mailing Address
First Line : HOPE ORTHOTICS, LLC - ATTN: MAYA GOUGEON, LO
Second Line : 230 SPRING HILL DRIVE, SUITE 335
City : SPRING
State : TX
Zip : 77386-2388
Country : US
Telephone Number : 877-297-8999
Fax Number : 877-206-0482
Provider Business Practice Location Address
First Line : HOPE ORTHOTICS, LLC - ATTN: MAYA GOUGEON, LO
Second Line : 230 SPRING HILL DRIVE, SUITE 335
City : SPRING
State : TX
Zip : 77386-2388
Country : US
Telephone Number : 877-297-8999
Fax Number : 877-206-0482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 07/08/2019

Similar Medicare Providers

1487652749 — HOPE ORTHOTICS, LLC
Practice Location Address:
230 SPRING HILL DR STE 335
SPRING, TX
77386-2388
Practice Phone: 281-296-8999
Practice Fax: 281-296-8989
1891058004 — SPENCER J SMITH CPO, LOP
Practice Location Address:
230 SPRING HILL DR , SUITE 335
SPRING, TX
77386-2388
Practice Phone: 281-296-8999
Practice Fax: 281-296-8989
1386909448 — RICHARD SHAW LOA, MPT
Practice Location Address:
230 SPRING HILL DRIVE , SUITE 335
SPRING, TX
77386-2388
Practice Phone: 281-296-8999
Practice Fax: 281-296-8989
1780949834 — ANNE PARE CO, LO
Practice Location Address:
230 SPRING HILL DRIVE , SUITE 335
SPRING, TX
77386-2388
Practice Phone: 281-296-8999
Practice Fax: 281-296-8989
1013272178 — JASON HENRY LO
Practice Location Address:
230 SPRING HILL DRIVE , SUITE 335
SPRING, TX
77386-2388
Practice Phone: 281-296-8999
Practice Fax: 281-296-8989
1407370414 — KATELYN SUZANNE CUMMINGS CPO, LPO, MSOP
Practice Location Address:
230 SPRING HILL DR STE 335
SPRING, TX
77386-2388
Practice Phone: 877-297-8999
Practice Fax: 877-206-0482

Directions to “ MADELINE MAYA GOUGEON LICENSED ORTHOTIST” Practice Location

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