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Active NPI 1508639964 Individual Practitioner Female Practitioner

Imelda Pena , CPO

Prosthetist • Live Oak, TX

Professional Overview & Biography Verified Profile Summary

Imelda Pena, CPO is a registered healthcare professional specializing in Prosthetist in Live Oak, TX. Practice services are available at 12315 JUDSON RD STE 206 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12315 Judson Rd Ste 206

Live Oak, TX 782333264

Telephone 2106578100
Fax 2106578105
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Prosthetist in Live Oak, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 5.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Live Oak, TX (259 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-10-31
Prosthetist Primary Specialty

NUCC Taxonomy Code: 224P00000X

State License TX 1312

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.

Orthotist

NUCC Taxonomy Code: 222Z00000X

State License TX 1312

A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1093887440
NPI 1730325887

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 06, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location November 06, 2023

Registered at 12315 JUDSON RD STE 206, LIVE OAK, TX 782333264 (Tel: 2106578100)

📍
Updated Business Mailing Address November 06, 2023

Registered at 12315 JUDSON RD STE 206, LIVE OAK, TX 782333264 (Tel: 2106578100)

👤
Provider Name / Credentials Updated November 06, 2023

Recorded as IMELDA PENA, CPO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 06, 2023

Orthotist (License #1312 in TX)

🟢
Initial NPI Registration & Enumeration November 06, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508639964
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 06, 2023
Last Update: November 06, 2023
Sole Proprietor: No

Mailing Address

12315 Judson Rd Ste 206

Live Oak, TX 782333264

Phone: 2106578100

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.