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Providence Health Services Of Waco
Prosthetic/Orthotic Supplier in Waco, Texas
NPI 1073506457

Providence Health Services Of Waco is a Prosthetic/Orthotic Supplier based in Dallas, TX. Providence Health Services Of Waco practices in Waco, TX. The NPI Number for Providence Health Services Of Waco is 1073506457 and holds a License No. (Texas).

The current practice location address for Providence Health Services Of Waco is 540 Meadowlake Ctr, Waco, TX and can be reached out via phone at 254-741-2495 and via fax at 254-741-2496.

Location: 540 Meadowlake Ctr, Waco, TX, 75320-1157
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073506457
Provider Name
Providence Health Services Of Waco
Credential
Provider Entity Type
Organization
Address
540 Meadowlake Ctr, Waco, TX, 75320-1157
Phone Number
254-741-2495
Fax Number
254-741-2496
Provider Enumeration Date
08/31/2005
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
087277201 05 TX
515091 01 BLUE CROSS BLUE SHIELD
016043401 05 TX
institution
Provider Business Practice Location Address Details
Address
540 Meadowlake Ctr
City
Waco
State
Texas
Zip
76712-3981
Phone Number
254-741-2495
Fax Number
254-741-2496
person
Provider Business Mailing Address Details
Address
540 Meadowlake Ctr
City
Waco
State
Texas
Zip
76712-3981
Phone Number
254-741-2495
Fax Number
254-741-2496
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
000111 (Texas)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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