Organization Name: | INNOVATIVE PROSTHETICS INC |
NPI Number: | 1578917654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA MARIE WILLIAMS (OWNER/BUSINESS MANAGER) |
Mailing Address: | 935 S Kimball Ave Ste 170 Southlake |
State: | TX US |
Postal Code: | 760929032 |
Phone Number: | 8669230515 |
Fax Number: | 8669815223 |
NPI Enumeration Date: | 04/14/2016 |
NPI Last Update Date: | 04/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |