Provider Demographics
NPI:1437692290
Name:NEW HOPE PROSTHETICS TEXARKANA LLC
Entity Type:Organization
Organization Name:NEW HOPE PROSTHETICS TEXARKANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GALSTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:CP
Authorized Official - Phone:870-489-1803
Mailing Address - Street 1:5485 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4608
Mailing Address - Country:US
Mailing Address - Phone:903-832-0016
Mailing Address - Fax:903-832-0335
Practice Address - Street 1:5485 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4608
Practice Address - Country:US
Practice Address - Phone:903-832-0016
Practice Address - Fax:903-832-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier