Organization
SMITH'S ORTHOPEDIC SHOES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI SMITH (SECRETARY TREASURER)
(432) 363-4271
Entity
Organization
Contact information
Practice address
5101 TWIN TOWERS BLVD, ODESSA, TX 79762-5504
(432) 363-4271
Mailing address
5101 TWIN TOWERS BLVD, ODESSA, TX 79762-5504
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
332BC3200X
Customized Equipment (DME)
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0865990-01
—
TX
01
—
504892
BLUE CROSS
TX
Enumeration date
11/07/2006
Last updated
07/21/2022
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