PROSTHETICARE FORT WORTH LP (NPI# 1295959492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295959492 |
| Entity Type | Organization |
| Organization Name | PROSTHETICARE FORT WORTH LP |
| Practice Address |
6116 Oakbend Trl Suite 100 Fort Worth TX 76132-3925 |
| Practice Telephone | 8173368293 |
| Practice Fax Number | 8173369017 |
| Mailing Telephone | 8173368293 |
| Mailing Fax Number | 8173369017 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2011-07-14 |
| Authorized Official Name | MR. TIMOTHY PATRICK GOLDBERG (OWNER/PRESIDENT) |
| Authorized Official Telephone | 8173368293 |
| Authorized Official Credential | CPLPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 10128 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CHAMPUS ID NUMBER | 061254040761040000 | 01 |
| TX | CSHCN ID NUMBER | 62856 | 01 |
| TX | PCA HEALTH PLANS ID NUMBE | 824704 | 01 |
| TX | AMERICAID AMERIGROUP ID | 48393 | 01 |
| TX | UNITED HEALTHCARE ID NUMB | 80227 | 01 |
| TX | AETNA ID NUMBER | 8540817 | 01 |
| TX | 087392901 | 05 | |
| TX | BLUECROSSBLUESHIELD OF TX | 519839 | 01 |
| TX | SECURE HORIZONS ID NUMBER | 10689 | 01 |
| Street Address |
6116 OAKBEND TRL SUITE 100 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76132-3925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194776872 | Metroplex Medical Rehabilitation & Sports Medicine Pa | Physical Medicine & Rehabilitation | 6116 Oakbend Trl, Suite 112, Fort Worth, TX 76132-3925 | 2006-05-15 |
| 1588055354 | Trista Preda | Nurse Practitioner | 6116 Oakbend Trl, Fort Worth, TX 76132-3925 | 2015-02-13 |
| 1437550613 | Ralph A Brooks, M.d. LLC | Dermatology | 6116 Oakbend Trl, Fort Worth, TX 76132-3925 | 2014-09-08 |
| 1699175059 | Gary L Campbell Do Pa | Physical Medicine & Rehabilitation | 6116 Oakbend Trl, Ste 112, Fort Worth, TX 76132-3925 | 2014-09-03 |
| 1447669312 | Tarrant County Institute of Physical Medicine LLP | Physical Medicine & Rehabilitation | 6116 Oakbend Trl, Suite 112, Fort Worth, TX 76132-3925 | 2014-08-05 |
| 1124369459 | Dehaven Diagnostics, LLC | Physical Medicine & Rehabilitation | 6116 Oakbend Trl, Suite 106, Fort Worth, TX 76132-3925 | 2013-03-12 |
| 1093823791 | Gary Campbell | Physical Medicine & Rehabilitation | 6116 Oakbend Trl, Suite 112, Fort Worth, TX 76132-3925 | 2006-08-25 |
| 1467565762 | Ralph Anthony Brooks | Dermatology | 6116 Oakbend Trl, Fort Worth, TX 76132-3925 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568878114 | Rgh Enterprises, Inc. | Prosthetic/Orthotic Supplier | 5400 Sandshell Dr, Fort Worth, TX 76137-2482 | 2014-07-03 |
| 1649524125 | En'style Hair & Total Image Studio | Prosthetic/Orthotic Supplier | 1173 Sunderland Lane, Fort Worth, TX 76134 | 2012-11-05 |
| 1639440126 | Foot Solutions of Fort Worth, Inc. | Prosthetic/Orthotic Supplier | 4825 Overton Ridge Blvd, Suite 316, Fort Worth, TX 76132-1423 | 2012-01-16 |
| 1669778916 | Survivor Gals Specialty Products and Salon LLC | Prosthetic/Orthotic Supplier | 1400 8th Ave Ste 100-a, Fort Worth, TX 76104-4110 | 2011-02-03 |
| 1770751950 | Brilliant Medical Boutique, LLC | Prosthetic/Orthotic Supplier | 6800 Harris Pkwy Ste 300, Fort Worth, TX 76132-4262 | 2008-02-11 |
| 1902925514 | Texas Orthotic and Prosthetic Systems, Inc. | Prosthetic/Orthotic Supplier | 1226 S Lake St, Fort Worth, TX 76104-4311 | 2007-03-28 |
| 1942398078 | Baker O & P Enterprises Inc | Prosthetic/Orthotic Supplier | 810 Lipscomb St, Fort Worth, TX 76104-3116 | 2006-10-11 |
| 1144296476 | Texas Orthotic & Prosthetic Systems Inc | Prosthetic/Orthotic Supplier | 1226 South Lake St, Fort Worth, TX 76104 | 2006-02-27 |
| 1922000140 | Hentz Medical, Inc | Prosthetic/Orthotic Supplier | 900 Hemphill St, Fort Worth, TX 76104-3110 | 2005-06-01 |
| 1851719918 | Cranial Technologies Inc. | Prosthetic/Orthotic Supplier | 800 8th Ave, Suite 124, Fort Worth, TX 76104-2601 | 2014-04-04 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76132 |
Please comment or provide details below to improve the information on PROSTHETICARE FORT WORTH LP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.