Provider Demographics
NPI:1649562539
Name:ADVANCED ORTHOTICS & PROSTHETICS LLC
Entity Type:Organization
Organization Name:ADVANCED ORTHOTICS & PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SOLOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-545-6956
Mailing Address - Street 1:11011 S WILCREST DR STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4346
Mailing Address - Country:US
Mailing Address - Phone:281-606-0849
Mailing Address - Fax:866-526-1020
Practice Address - Street 1:11011 S WILCREST DR STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4346
Practice Address - Country:US
Practice Address - Phone:281-606-0849
Practice Address - Fax:866-526-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier