Organization
ORTHOTICS SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI WELLS (DIRECTOR OF OPERATIONS)
(210) 698-9377
Entity
Organization
Contact information
Practice address
ORTHOTICS SPECIALIST DBA HILL COUNTRY ORTHOTICS AND PRO, 6631 S ZARZAMORA ST, SAN ANTONIO, TX 78211
(210) 977-0166
(210) 977-0168
Mailing address
4242 MEDICAL DR STE 2100, SAN ANTONIO, TX 78229-5641
(210) 698-9377
(210) 698-2544
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101184
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171115204
—
TX
01
—
531770
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/26/2007
Last updated
01/14/2020
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