Organization
LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA LETOURNEAU (CFO, SECRETARY, TREASURER)
(409) 832-5005
Entity
Organization
Contact information
Practice address
2452 CALDER ST, BEAUMONT, TX 77702
(409) 832-5005
(409) 832-5015
Mailing address
PO BOX 21698, BEAUMONT, TX 77720
(409) 832-5005
(409) 832-5015
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101504
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091362601
—
TX
01
—
5192085
BLUE CROSS BLUE SHEILD TX
TX
Enumeration date
09/13/2006
Last updated
02/23/2017
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