Prosthetic-Orthotic Associates of East Texas, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC-ORTHOTIC ASSOCIATES OF EAST TEXAS, INC.

Practice address

713 N 4TH St Ste 2
Longview, TX 75601-5412

Phone

(430) 240-8767

Fax

(430) 240-4475

NPI assigned

Aug 25, 2025

Organization subpart

Yes

Parent organization

PROSTHETIC-ORTHOTIC ASSOCIATES OF EAST TEXAS, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce P McClellan, CPONPI 1104976182

Title

President

Phone

(903) 592-6574

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Prosthetic-Orthotic Associates of East Texas, Inc.

  • Prosthetic/Orthotic Supplier
  • Tyler, TX
  • NPI 1780624148

  3678691219

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Prosthetic-Orthotic Associates of East Texas Inc2 organizations share this tax ID, including this one

Part of

Prosthetic-Orthotic Associates of East Texas Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prosthetic-Orthotic Associates of East Texas, Inc.

  • Prosthetic/Orthotic Supplier
  • Tyler, TX
  • NPI 1780624148
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Prosthetic-Orthotic Associates of East Texas, Inc.

  • Prosthetic/Orthotic Supplier
  • Tyler, TX
  • NPI 1780624148
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce Patrick McClellan, C.P.O.

  • Orthotist
  • Tyler, TX
  • NPI 1104976182
  NPD (past) Authorized official
• Amy Hicks, MSN FNP-C

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1356727077
  NPD (past)
• Matthew Bruce McClellan, C.P.O.

  • Prosthetist
  • Tyler, TX
  • NPI 1073134177
  NPD (past)
• Uma Pulipaka, M.D.

  • Neurology Physician
  • Longview, TX
  • NPI 1700881562
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1083592364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 E IDEL ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012024",
            "telephone_number": "903-592-6574",
            "fax_number": "903-595-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N 4TH ST STE 2",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015412",
            "telephone_number": "430-240-8767",
            "fax_number": "430-240-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC-ORTHOTIC ASSOCIATES OF EAST TEXAS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROSTHETIC-ORTHOTIC ASSOCIATES OF EAST TEXAS, INC.",
        "enumeration_date": "2025-08-25",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-592-6574",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Longview, TX
• Providers in Longview, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.