Custom Care Orthopedic Bracing Llc

LBN: Steven G Mccullough
Custom Care Orthopedic Bracing Llc is an health care organization with primary practice located at 1120 Medical Dr , Tyler TX 75701-2109. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Steven G Mccullough can be contacted via phone (903) 592-5900, or through Mccullough, Steven Glenn via phone (903) 592-5900.

Contact Information

Primary practice address
1120 Medical Dr Tyler TX 75701-2109
Phone: (903) 592-5900
Fax: (903) 592-6683
Website:
Map and Directions
Authorized official contact:
Name: Mccullough, Steven Glenn CERTIFIED ORTHOTIST
Phone: (903) 592-5900

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X 101171 Texas

Profile Details

NPI number 1932363751
LBN Legal business name Steven G Mccullough
DBA Doing business as Custom Care Orthopedic Bracing Llc
Authorized official Mccullough, Steven Glenn CERTIFIED ORTHOTIST
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2008
Last updated Jul 10th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932363751 NPPES
Texas MEDICAID 087070101

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