Individual provider · Type 1 NPI
Kellie Leday
Prosthetic/Orthotic Supplier · Beaumont, TX
Practice location
3965 Phelan Blvd Ste 104
Beaumont, TX 77707-2253
Mailing address
5595 Bonnie Lee St
Beaumont, TX 77705-6006
Other practice locations
- 5595 Bonnie Lee St, Beaumont, TX 77705-6006 · (832) 693-2213
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | P8WUN1JA8R (TX) |
| Prosthetic/Orthotic Supplier Primary | 335E00000X | P8WUN1JA8R (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.
About NPI 1972357796
Kellie Leday's National Provider Identifier is 1972357796, issued on Apr 17, 2024. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Beaumont, TX. The record was last updated on Jun 19, 2025.