Provider Demographics
NPI:1508471335
Name:TEXAS ORTHOPEDIC NETWORK, LLC
Entity Type:Organization
Organization Name:TEXAS ORTHOPEDIC NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:SOLE MBR
Authorized Official - Phone:833-715-0726
Mailing Address - Street 1:8660 S PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-2827
Mailing Address - Country:US
Mailing Address - Phone:918-528-3832
Mailing Address - Fax:
Practice Address - Street 1:825 WATTERS CREEK BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3770
Practice Address - Country:US
Practice Address - Phone:833-715-0726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier