NPI age
17 years
Enumerated 2009-03-16
● Active Type 2 · Organization
Subpart
Providence Health Services Of Waco, Inc
Providence Health Services Of Waco, Inc is 1 of 741 prosthetic/orthotic supplier organizations in Texas.
Primary specialty
Prosthetic/Orthotic Supplier
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Nichols
Coo
Last NPPES update
2010-08-04
Source: monthly bulk 2026-05
How this organization compares
Across 741 active prosthetic/orthotic supplier providers in Texas.
NPI age
17 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2009 → 2026
2009-03Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
6600 Fish Pond Road, Suite 104
Waco, TX 76710
Mailing address
540 Meadowlake Center
Waco, TX 76712
Authorized official
Odis W. Nichols
Coo
📞 2547514000
Specialties
-
Prosthetic/Orthotic Supplier PrimaryAn organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0160434-01 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Providence Medical Equipment Services
Practice context
Single-site organization. Only one practice location on file.
Subpart of Providence Health Services Of Waco, Inc.
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.