MEDICARE: ORTHOTICS PLUS LLC

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	335E00000X	Prosthetic/Orthotic Supplier	445	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780862664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOTICS PLUS LLC

Provider Business Mailing Address
First Line	:	2122 BABCOCK RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4468
Country	:	US
Telephone Number	:	210-692-1111
Fax Number	:	210-692-6041

Provider Business Practice Location Address
First Line	:	2122 BABCOCK RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4411
Country	:	US
Telephone Number	:	210-692-1111
Fax Number	:	210-692-6041

Authorized Official
Title or Position	:	MANAGER
Name	:	TYLER FLAVIN
Credential	:	CPO/LO
Telephone Number	:	210-692-1111

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	03/13/2026

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Directions to “ORTHOTICS PLUS LLC ” Practice Location

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