Organization
OTTO BOCK ORTHOPEDIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LEWIS (EVP OF LICENSURE)
(512) 806-2756
Entity
Organization
Contact information
Practice address
555 ROUND ROCK WEST DR STE E213, ROUND ROCK, TX 78681-5052
(800) 736-8276
(866) 642-2302
Mailing address
PO BOX 734949, DALLAS, TX 75373-4949
(800) 736-8276
(866) 642-2302
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001707
DEVICE DISTRIBUTOR LICENSE
TX
05
—
404809201
—
TX
01
—
MP01413
NV STATE BOP-MEDICAL DEVICES, EQUIPMENT, GAS
NV
01
—
R4009
MD DEPT OF HEALTH & MENTAL HYGIENE-RESIDENTIAL SERVICE AGENCY
MD
Enumeration date
10/08/2009
Last updated
01/30/2026
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