Provider Demographics
NPI:1437974276
Name:NEW LIFE BRACE AND LIMB, LLC
Entity type:Organization
Organization Name:NEW LIFE BRACE AND LIMB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-440-7000
Mailing Address - Street 1:250 BLOSSOM STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-316-5805
Mailing Address - Fax:281-316-5970
Practice Address - Street 1:205 N. STAR DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904
Practice Address - Country:US
Practice Address - Phone:361-579-2990
Practice Address - Fax:361-579-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier