Provider Demographics
NPI:1689716441
Name:ORTHOTIC SOLUTIONS GROUP, INC.
Entity Type:Organization
Organization Name:ORTHOTIC SOLUTIONS GROUP, INC.
Other - Org Name:ORTHOTIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-295-2124
Mailing Address - Street 1:2457 S LOOP 4 STE 1A
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-9329
Mailing Address - Country:US
Mailing Address - Phone:512-295-2124
Mailing Address - Fax:512-295-2309
Practice Address - Street 1:2457 S LOOP 4 STE 1A
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-9329
Practice Address - Country:US
Practice Address - Phone:512-295-2124
Practice Address - Fax:512-295-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier