1154961456 NPI number — H5 PROSTHETICS AND ORTHOTICS LLC

Table of content: MEGAN MARIE FITZGERALD MSW (NPI 1538892534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154961456 NPI number — H5 PROSTHETICS AND ORTHOTICS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
H5 PROSTHETICS AND 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:
Provider Other Organization Name Type Code:
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:
1154961456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7410 JOHN SMITH DR STE 213
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-6000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-481-4473
Provider Business Mailing Address Fax Number:
210-481-4479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7410 JOHN SMITH DR STE 213
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-481-4473
Provider Business Practice Location Address Fax Number:
210-481-4479
Provider Enumeration Date:
01/14/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HERRERA
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
GOMEZ
Authorized Official Title or Position:
OWNER / CEO
Authorized Official Telephone Number:
210-481-4473

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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