Organization
TEXAS ORTHOTIC & PROSTHETIC SYSTEMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART LEIGH WILLETT (OFFICE MGR)
(817) 810-0901
Entity
Organization
Contact information
Practice address
1226 SOUTH LAKE ST, FORT WORTH, TX 76104
(817) 810-0901
(817) 810-0903
Mailing address
1226 SOUTH LAKE ST, FORT WORTH, TX 76104
(817) 810-0901
(817) 810-0903
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101193
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10030707
AMERI GROUP
TX
01
—
530908
BCBS
TX
01
—
6491456
AETNA
TX
Enumeration date
02/27/2006
Last updated
08/22/2020
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