Organization
LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAN A SAUNDERS (SENIOR VICE PRESIDENT)
(336) 397-2165
Entity
Organization
Contact information
Practice address
1601 HIGHWAY 59 LOOP N, STE 500, LIVINGSTON, TX 77351-6685
(936) 327-2115
(936) 327-2116
Mailing address
PO BOX 24128, WINSTON SALEM, NC 27114-4128
(336) 397-2165
(336) 397-2167
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101505
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207098901
—
TX
01
—
519208
BCBS
TX
Enumeration date
10/10/2006
Last updated
04/07/2015
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