MEDICARE: BRACE SPECIALISTS 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1841781044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRACE SPECIALISTS LLC.

Provider Business Mailing Address
First Line	:	5614 W GRAND PKWY S STE 102-128
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5614 W GRAND PKWY S STE 102-128
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5820
Country	:	US
Telephone Number	:	281-215-4105
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. TAHIR ALI
Credential	:
Telephone Number	:	281-215-4105

Provider Enumeration Date	:	05/23/2018
Last Update Date	:	05/23/2018

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