Organization
VRAI PROSTHETIC CARE P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR DE LA FUENTE LP, BOCP (OWNER)
(903) 553-1040
Entity
Organization
Contact information
Practice address
719 N 2ND ST, LONGVIEW, TX 75601-5402
(903) 553-1040
(903) 553-9996
Mailing address
719 N 2ND ST, LONGVIEW, TX 75601-5402
(903) 553-1040
(903) 553-9996
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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