| NPI | 1639368970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PENNELL Practice Administrator 281-348-2166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1555) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2024-05-03 |