PROVIDENCE HEALTH SERVICES OF WACO, INC (NPI# 1902047285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902047285 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SERVICES OF WACO, INC |
| Other Organization Name | PROVIDENCE MEDICAL EQUIPMENT SERVICES |
| Practice Address |
6600 Fish Pond Road Suite 104 Waco TX 76710 |
| Mailing Address |
540 Meadowlake Center Waco TX 76712 |
| Practice Telephone | 2547412495 |
| Mailing Telephone | 2547412495 |
| Mailing Fax Number | 2547412496 |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2010-08-04 |
| Authorized Official Name | MR. ODIS W. NICHOLS JR. (COO) |
| Authorized Official Telephone | 2547514000 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH SERVICES OF WACO, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 0160434-01 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Medical Equipment Services | Doing Business As Name - Organization |
| Street Address |
6600 FISH POND ROAD SUITE 104 |
| City | WACO |
| State | TX |
| Zip Code | 76710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740741156 | Jessica Cook-lindsay | Physical Therapist | 2121 W Hwy 6, Waco, Waco, TX 76710 | 2019-03-28 |
| 1306354824 | Paula A Huffhines | Technician, Other | 115 S 25th, Waco, TX 76710 | 2018-01-18 |
| 1982154639 | Nha Do | Pharmacist | 1301 Wood Acres, Waco, TX 76710 | 2016-10-06 |
| 1649662495 | Pediatric Advanced Life Services Home Health LLC | Home Health | 3640 W Waco Dr, Waco, TX 76710 | 2015-03-02 |
| 1881008795 | Soumava Sen, Dds, P.C. | Dentist | 4215 Franklin Ave, Ste. 300, Waco, TX 76710 | 2014-06-18 |
| 1053742221 | Dustin Dwain Kelm | Physical Therapist | 5400 Laurel Dr., Waco, TX 76710 | 2013-12-12 |
| 1881038776 | Penelope Diane Lane | Counselor | 7524 Bosque, Waco, TX 76710 | 2013-04-22 |
| 1538400627 | Erik Alexander Pernes Caluscusao | Physical Therapist | 415 Owen Ln Apt 911, Waco, TX 76710 | 2013-03-14 |
| 1447509039 | Sheree L Mach | Occupational Therapist | 5400 Laurel Lake Dr., Waco, TX 76710 | 2012-08-29 |
| 1568738425 | Ramanathan Anandaraman | Internal Medicine | 2608 Skyline Drive, Waco, TX 76710 | 2012-03-26 |
| Find all providers in zip 76710 | ||||
| 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 |
|---|---|---|---|---|
| 1881182640 | Waco Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 201 Colonnade Pkwy Ste 101, Waco, TX 76712-6174 | 2018-04-27 |
| 1528163128 | Rmd & K Inc | Prosthetic/Orthotic Supplier | 7724 Central Park Dr, Waco, TX 76712-6535 | 2006-09-14 |
| 1003886003 | Elite Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 2105 Franklin Ave, Waco, TX 76701 | 2006-01-24 |
| 1588647226 | United Rehab Specialists, Inc. | Prosthetic/Orthotic Supplier | 6807b Woodway Dr, Waco, TX 76712-6146 | 2005-11-28 |
| 1073506457 | Providence Health Services of Waco | Prosthetic/Orthotic Supplier | 540 Meadowlake Ctr, Waco, TX 76712-3981 | 2005-08-31 |
| 1003387218 | Elite Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2105 Franklin Ave, Waco, TX 76701-1632 | 2018-12-16 |
| 1134526296 | Advanced Prosthetic Research Waco, Inc. | Prosthetic/Orthotic Supplier | 2410 Wycon Dr, Ste 101, Waco, TX 76712-8957 | 2014-12-04 |
| 1881921450 | Twin City Orthotics & Prosthetics of Waco | Prosthetic/Orthotic Supplier | 6600 Sanger Ave, Suite 13, Waco, TX 76710-7814 | 2009-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627997 | Tactical Rehabilitation Inc | Prosthetic/Orthotic Supplier | 2710 S. Clear Creek, Suite 110, Killeen, TX 76549-6685 | 2020-10-22 |
| 1962001123 | Tactical Rehabilitation Inc | Prosthetic/Orthotic Supplier | 2710 Clear Creek Rd Apt 110, Killeen, TX 76549-6685 | 2020-10-20 |
| 1871191643 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 2020 W State Highway 114 Ste 360, Grapevine, TX 76051-8649 | 2020-10-14 |
| 1396351573 | Baker O & P Enterprises, Inc. | Prosthetic/Orthotic Supplier | 1104 West 34th St., Bldg. A, Austin, TX 78705-1910 | 2020-09-22 |
| 1184230815 | Lindas Signature Hair Studio Inc | Prosthetic/Orthotic Supplier | 9415 Broadway St Ste 201, Pearland, TX 77584-8094 | 2020-09-18 |
| 1538773106 | Memorial Prosthetics and Orthotics Inc | Prosthetic/Orthotic Supplier | 439 Mason Park Blvd Ste A1, Katy, TX 77450-4163 | 2020-09-01 |
| 1447861828 | Major Miracles Rx | Prosthetic/Orthotic Supplier | 1801 E 51st St Ste 362, Austin, TX 78723-3434 | 2020-08-11 |
| 1396355061 | Ameristep Prosthetics San Antonio | Prosthetic/Orthotic Supplier | 7271 Wurzbach Rd Ste 187, San Antonio, TX 78240-3800 | 2020-08-06 |
| 1043820327 | Ameristep Prosthetics Southwestern | Prosthetic/Orthotic Supplier | 5406 Harry Hines Blvd, Dallas, TX 75235-7211 | 2020-08-03 |
| 1083230502 | Amazing Wig Closet | Prosthetic/Orthotic Supplier | 409 W Front St Ste 100-306, Hutto, TX 78634-4204 | 2020-06-20 |
| Find all providers with the same taxonomy | ||||
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| 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.