NPIMap

Organization Active NPI

Letourneau Lifelike Orthotics & Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Beaumont, TX
National Provider Identifier
1407951510
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
101504 Issued in TX
Legal business name
LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC
Practice address
2452 Calder St
Beaumont, TX 77702
Phone
(409) 832-5005
Fax
(409) 832-5015
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Sandra Letourneau
Title
Cfo, Secretary, Treasurer
Phone
(409) 832-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 101504 TX Primary

Addresses

Primary practice location

2452 Calder St
Beaumont, TX 77702

Mailing address

PO Box 21698
Beaumont, TX 77720
Phone (409) 832-5005

Other identifiers 2

IdentifierTypeStateIssuer
091362601MedicaidTX
5192085OtherTXBLUE CROSS BLUE SHEILD TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930065648 TX DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 9335269133 Practice locations: Beaumont, TX

Other NPIs with the same Medicare PAC ID 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Letourneau Lifelike Ortho & Pros in2452 Calder St, Beaumont, TX 77702-1920(409) 832-5005 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Letourneau Lifelike Orthotics Prosthetics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3522 Highway 365
Nederland, TX 77627
Phone (409) 832-5005

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1407951510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21698",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77720",
            "telephone_number": "409-832-5005",
            "fax_number": "409-832-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 CALDER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-832-5005",
            "fax_number": "409-832-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "LETOURNEAU",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CFO, SECRETARY, TREASURER",
        "authorized_official_telephone_number": "409-832-5005"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091362601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD TX",
            "identifier": "5192085",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.