1487652749 NPI number — HOPE ORTHOTICS, LLC

Table of content: (NPI 1487652749)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487652749 NPI number — HOPE ORTHOTICS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE ORTHOTICS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRANSCEND ORTHOTICS & PROSTHETICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487652749
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 650846
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75265-0846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 SPRING HILL DR STE 335
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77386-2388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-296-8999
Provider Business Practice Location Address Fax Number:
281-296-8989
Provider Enumeration Date:
07/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANGELINE
Authorized Official First Name:
GRACE
Authorized Official Middle Name:
Authorized Official Title or Position:
REG COMPLIANCE SPECIALIST IV
Authorized Official Telephone Number:
714-961-2102

Provider Taxonomy Codes

  • Taxonomy code: 222Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 224P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 1000733 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , with the licence number: 101407 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0108144-03 . This is a "CWSHCN TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 30959 . This is a "AMERIGROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "DARS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0108144-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0108144-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0108144-03 . This is a "CWSHLN-TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 30959 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 530321 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".