Organization
PROSTHETIC-ORTHOTIC ASSOCIATES OF NORTH TEXAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE P. MCCLELLAN C.P.O. (PRESIDENT)
(903) 592-6574
Entity
Organization
Contact information
Practice address
376 W MAIN ST, SUITE G, LEWISVILLE, TX 75057-3866
(972) 221-7607
(972) 420-0525
Mailing address
376 W MAIN ST, SUITE G, LEWISVILLE, TX 75057-3866
(972) 221-7607
(972) 420-0525
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
000085
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
509124
BCBS-TEXAS
—
Enumeration date
06/10/2006
Last updated
08/22/2020
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