MEDICARE: TIM C HOWELL CPO,LPO

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	224P00000X	Prosthetist
2	222Z00000X	Orthotist

General Provider Information

NPI Number	:	1710248489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIM C HOWELL CPO,LPO

Provider Business Mailing Address
First Line	:	623 N SAM HOUSTON AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-4434
Country	:	US
Telephone Number	:	432-337-8880
Fax Number	:	432-337-8887

Provider Business Practice Location Address
First Line	:	623 N SAM HOUSTON AVE
Second Line	:
City	:	ODESSA
State	:	TX
Zip	:	79761-4434
Country	:	US
Telephone Number	:	432-337-8880
Fax Number	:	432-337-8887

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	10/24/2018

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