DOUGLASS JOHN WACKER C.P.O. NPI 1790927192

NPI Information

NPI: 1790927192
Provider Name: DOUGLASS JOHN WACKER, C.P.O.
Classification: Prosthetist - 224P00000X
Entity Type: Individual
Address:
3900 LA BRANCH ST
HOUSTON, TX
ZIP 77004
Phone: (713) 524-3949
Get Directions

Douglass John Wacker, C.P.O. is a prosthetist in Houston, TX. The provider is a health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. Douglass John Wacker, C.P.O. NPI is 1790927192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3900 LA BRANCH ST
HOUSTON, TX
ZIP 77004-046
Phone: (713) 524-3949
Fax: (713) 524-3915

The enumeration date for this NPI number is 3/31/2009 and was last updated on 11/30/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	222Z00000X	Orthotist		85	TEXAS	No
2	224P00000X	Prosthetist		85	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PO0012	MEDICAID	TEXAS
2	0210750001	MEDICARE NSC	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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