Basic Information
| Provider Information | |||||||||
| NPI: | 1790755742 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED SEATING AND MOBILITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2070 LITTLE HILLS EXPY | ||||||||
| Address2: | |||||||||
| City: | SAINT CHARLES | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633013708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144477500 | ||||||||
| FaxNumber: | 3144477830 | ||||||||
| Practice Location | |||||||||
| Address1: | 2030 N HIGHWAY 360 | ||||||||
| Address2: | |||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750501423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8173772225 | ||||||||
| FaxNumber: | 8173772250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING AND LICENSURE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3144477515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 07088917 | TX | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 144465504 | 05 | TX | MEDICAID | 017600-01 | 01 | TX | PACIFICARE OF TX | OTHER | 145457101 | 01 | TX | SUPERIOR HEALTH PLAN | OTHER | 145457101 | 05 | TX | MEDICAID | 531032 | 01 | TX | BCBS OF TX | OTHER | 141330100 | 01 | TX | US DEPT. OF LABOR | OTHER | 1444655-02 | 01 | TX | CSHCN | OTHER | 10006343 | 01 | TX | AMERIGROUP | OTHER | 10465 | 01 | TX | PARKLAND COMMUNITY HEALTH | OTHER | 1444655-03 | 01 | TX | CSHCN NON-CUSTOM | OTHER | 276581 | 01 | TX | AETNA NATIONAL HMO | OTHER | 251910864 | 01 | TX | GREAT WEST LIFE & ANNUITY | OTHER | 145456301 | 05 | TX | MEDICAID | 407109 | 01 | TX | HUMANA CHOICE CARE | OTHER | 7282299 | 01 | TX | AETNA NATIONAL NON-HMO | OTHER |