Provider Demographics
NPI:1578548723
Name:MICHELLE RANSOM-ROBINSON
Entity Type:Organization
Organization Name:MICHELLE RANSOM-ROBINSON
Other - Org Name:TEXAS ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RANSOM-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-626-3722
Mailing Address - Street 1:1705 S FM 51
Mailing Address - Street 2:SUITE 109
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3645
Mailing Address - Country:US
Mailing Address - Phone:940-626-3722
Mailing Address - Fax:940-626-3724
Practice Address - Street 1:1705 S FM 51
Practice Address - Street 2:SUITE 109
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3645
Practice Address - Country:US
Practice Address - Phone:940-626-3722
Practice Address - Fax:940-626-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0071304332B00000X
TX101090335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1560781-01Medicaid
TX1591343OtherCIGNA
TX531001OtherBLUE CROSS BLUE SHIELD
TX1560781-01Medicaid
TX=========OtherUNICARE
TX1591343OtherCIGNA