Provider Demographics
NPI:1760679450
Name:RIO PROSTHETICS, INC.
Entity Type:Organization
Organization Name:RIO PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-821-0725
Mailing Address - Street 1:201 W HILLSIDE RD STE 25
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3197
Mailing Address - Country:US
Mailing Address - Phone:956-717-9400
Mailing Address - Fax:956-717-9401
Practice Address - Street 1:201 W HILLSIDE RD STE 25
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3197
Practice Address - Country:US
Practice Address - Phone:956-717-9400
Practice Address - Fax:956-717-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101241332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194269001Medicaid
TX532647OtherBLUECROSS BLUESHIELD OF TEXAS
TX532647OtherBLUECROSS BLUESHIELD OF TEXAS