Organization
NUTECH ORTHOTICS & PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLASS J. WACKER CPO, LPO (MEMBER, MANAGER)
(956) 412-5347
Entity
Organization
Contact information
Practice address
501 N ED CAREY DR, STE A, HARLINGEN, TX 78550-8358
(956) 412-5347
(956) 412-3563
Mailing address
501 N ED CAREY DR, STE A, HARLINGEN, TX 78550-8358
(956) 412-5347
(956) 412-3563
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
85
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172779401
—
TX
05
—
172779404
—
TX
05
—
179772402
—
TX
05
—
179772403
—
TX
Enumeration date
06/01/2006
Last updated
11/23/2010
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