| NPI | 1376004614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LEWIS EVP Of Licensure 512-806-2756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-10-22 |