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East Texas Prosthetic-orthotic Care
Prosthetic/Orthotic Supplier in Longview, Texas
NPI 1508048984

East Texas Prosthetic-orthotic Care is a Prosthetic/Orthotic Supplier based in Longview, TX. East Texas Prosthetic-orthotic Care practices in Longview, TX. The NPI Number for East Texas Prosthetic-orthotic Care is 1508048984 and holds a License No. 000020 (Texas).

The current practice location address for East Texas Prosthetic-orthotic Care is 812 N 4Th St, Longview, TX and can be reached out via phone at 903-236-4488 and via fax at 903-236-4607.

Location: 812 N 4Th St, Longview, TX, 75601-5413
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1508048984
Provider Name
East Texas Prosthetic-orthotic Care
Credential
Provider Entity Type
Organization
Address
812 N 4Th St, Longview, TX, 75601-5413
Phone Number
903-236-4488
Fax Number
903-236-4607
Provider Enumeration Date
11/28/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
519698 01 TX BLUE CROSS BLUE SHIELD
010236001 05 TX
institution
Provider Business Practice Location Address Details
Address
812 N 4Th St
City
Longview
State
Texas
Zip
75601-5413
Phone Number
903-236-4488
Fax Number
903-236-4607
person
Provider Business Mailing Address Details
Address
812 N 4Th St
City
Longview
State
Texas
Zip
75601-5413
Phone Number
903-236-4488
Fax Number
903-236-4607
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
000020 (Texas)
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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