Provider Demographics
NPI:1215112016
Name:VICTORIA ORTHOPEDIC CENTER PLLC
Entity type:Organization
Organization Name:VICTORIA ORTHOPEDIC CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SPEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-576-0633
Mailing Address - Street 1:6404 NURSERY DR
Mailing Address - Street 2:STE 202
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1721
Mailing Address - Country:US
Mailing Address - Phone:361-576-0633
Mailing Address - Fax:361-576-0639
Practice Address - Street 1:6404 NURSERY DR.
Practice Address - Street 2:STE 202
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1721
Practice Address - Country:US
Practice Address - Phone:361-576-0633
Practice Address - Fax:361-576-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6081220001Medicare NSC