Provider Demographics
NPI:1811300502
Name:BEST ORTHOPEDIC RESOURCE GROUP
Entity type:Organization
Organization Name:BEST ORTHOPEDIC RESOURCE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAGOSO
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:210-859-5438
Mailing Address - Street 1:PO BOX 667090
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-7090
Mailing Address - Country:US
Mailing Address - Phone:210-859-5438
Mailing Address - Fax:
Practice Address - Street 1:1300 CASTLE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5702
Practice Address - Country:US
Practice Address - Phone:210-859-5438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00305363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty