Letourneau Lifelike Orthotics & Prosthetics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

101505 Issued in TX

Legal business name

LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC.

Practice address

1601 Highway 59 Loop N
Ste 500
Livingston, TX 77351-6685

Phone

(936) 327-2115

Fax

(936) 327-2116

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jan A Saunders

Title

Senior Vice President

Phone

(336) 397-2165

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 1

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

• Level Four Orthotics & Prosthetics, Inc.

  dba Restore POC

  • Prosthetic/Orthotic Supplier
  • Charlotte, NC
  • NPI 1922048313

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1790873685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24128",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271144128",
            "telephone_number": "336-397-2165",
            "fax_number": "336-397-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HIGHWAY 59 LOOP N",
            "address_2": "STE 500",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773516685",
            "telephone_number": "936-327-2115",
            "fax_number": "936-327-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETOURNEAU LIFELIKE ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "336-397-2165",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207098901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "519208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Lyn Larsen
• Matthew Paul Latta
• Kenneth J Laurora, MD
• Sharon Lawrence, RN
• David Wayne Lee Jr., APRN, FNP-C
• Sherry L Levesque, OTR
• Chris Lewis, DDS
• Liberty County Hospital District No 1 (Pine Ridge Health Care)
• Liberty County Hospital District No 1 (Timberwood Nursing and Rehabilitation Center)
• Jairo Andres Libreros, M.D.

• Prosthetic/Orthotic Supplier in Livingston, TX
• Providers in Livingston, 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 Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.