Custom Care Orthopedic Bracing And Prosthetics
LBN: Steven G Mccullough And David W Holt Orthotics & Prosthetics Llc
Custom Care Orthopedic Bracing And Prosthetics 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 And David W Holt Orthotics & Prosthetics Llc can be contacted via phone (903) 592-5900, or through Gardner, Bradford via phone (615) 864-8783.
Contact Information
Primary practice address
1120 Medical Dr
Tyler TX 75701-2109
Phone: (903) 592-5900
Fax: (903) 592-6683
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | 101171 | Texas |
Profile Details
| NPI number | 1215978424 |
|---|---|
| LBN Legal business name | Steven G Mccullough And David W Holt Orthotics & Prosthetics Llc |
| DBA Doing business as | Custom Care Orthopedic Bracing And Prosthetics |
| Authorized official | Gardner, Bradford |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jan 7th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215978424 | NPPES |
| Other | 519266 | BCBS | |
| MEDICAID | 087070101 | BCBS |
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