Individual
PAUL LANCIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
1901 S 1ST ST, TEMPLE, TX 76504-7451
(254) 743-2416
(254) 743-2348
Mailing address
1901 S 1ST ST, TEMPLE, TX 76504-7451
(254) 743-2416
(254) 743-2348
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPO03232
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS
—
Enumeration date
11/21/2018
Last updated
11/21/2018
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