Organization · Type 2 NPI

Steven G McCullough and David W Holt Orthotics & Prosthetics LLC

Prosthetic/Orthotic Supplier · Tyler, TX

NPI number 1215978424 Active

Practice location

1120 Medical Dr
Tyler, TX 75701-2109

Call (903) 592-5900 Map

Fax (903) 592-6683

Mailing address

102 Woodmont Blvd Ste 120
Nashville, TN 37205-5249

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	101171 (TX)

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.

Another provider at this address

Steven G McCulloughProsthetic/Orthotic Supplier Tyler, TX NPI 1932363751

Other prosthetic/orthotic supplier providers in Tyler

See all in Tyler →

NPI record

NPI: 1215978424
Entity type: Organization (Type 2)
Issued: Jun 9, 2006
Last updated: Jan 7, 2020
Status: Active

Other names

<unavail>
Custom Care Orthopedic Bracing and Prosthetics · doing business as
Custom Care Orthopedic Bracing and Prosthetics · doing business as

Authorized official

Mr. Bradford Gardner
COO
(615) 864-8783

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1215978424

Steven G McCullough and David W Holt Orthotics & Prosthetics LLC's National Provider Identifier is 1215978424, issued on Jun 9, 2006. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Tyler, TX. The record was last updated on Jan 7, 2020.