Organization
TEXOMA ORTHOTICS AND PROSTHETICS, PLLC
Active
Other names
Texoma O & P
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE M CHELENZA CO, L (OWNER)
(580) 699-8690
Entity
Organization
Contact information
Practice address
1915 W GORE BLVD, STE 1, LAWTON, OK 73501-3661
(580) 699-8690
(580) 699-8692
Mailing address
1915 W GORE BLVD, STE 1, LAWTON, OK 73501-3661
(580) 699-8690
(580) 699-8692
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
LPO86, LO52
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200472830 A
—
OK
Enumeration date
10/20/2012
Last updated
03/28/2013
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