Organization
PARK PROSTHETICS AND ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVID PARK C.P, L.P. (PRESIDENT)
(361) 888-5347
Entity
Organization
Contact information
Practice address
2222 MORGAN AVE, SUITE 110, CORPUS CHRISTI, TX 78405-1948
(361) 888-5347
(361) 888-5345
Mailing address
2222 MORGAN AVE, SUITE 110, CORPUS CHRISTI, TX 78405-1948
(361) 888-5347
(361) 888-5345
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039519
MEDICAL DEVICE MANUFACTUR
TX
01
—
101103
TEXAS BOARD OF O&P LIC.
TX
Enumeration date
05/10/2006
Last updated
08/22/2020
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