Provider Demographics
NPI:1629688999
Name:AMERISTEP PROSTHETICS DALLAS
Entity Type:Organization
Organization Name:AMERISTEP PROSTHETICS DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HOLDERBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-304-7500
Mailing Address - Street 1:5000 EL DORADO PKWY
Mailing Address - Street 2:150-142
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033
Mailing Address - Country:US
Mailing Address - Phone:682-304-7500
Mailing Address - Fax:
Practice Address - Street 1:200 COLE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-4018
Practice Address - Country:US
Practice Address - Phone:817-251-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier