Provider Demographics
NPI:1487652749
Name:HOPE ORTHOTICS, LLC
Entity type:Organization
Organization Name:HOPE ORTHOTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REG COMPLIANCE SPECIALIST IV
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-961-2102
Mailing Address - Street 1:P O BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 SPRING HILL DR STE 335
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2388
Practice Address - Country:US
Practice Address - Phone:281-296-8999
Practice Address - Fax:281-296-8989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-12
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Z00000X, 224P00000X
TX1000733332B00000X
TX101407335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0108144-03OtherCWSHCN TEXAS
TN30959OtherAMERIGROUP
TX=========OtherDARS
TX0108144-01Medicaid
TX0108144-02Medicaid
TX0108144-03OtherCWSHLN-TX
TX30959OtherAMERIGROUP
TX530321OtherBLUE CROSS BLUE SHIELD
TX0108144-03OtherCWSHCN TEXAS
TX0108144-03OtherCWSHCN TEXAS
TX530321OtherBLUE CROSS BLUE SHIELD