Provider Demographics
NPI:1891261046
Name:AXIS ORTHOTICS AND PROSTHETICS LLC
Entity Type:Organization
Organization Name:AXIS ORTHOTICS AND PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:CO,LPO
Authorized Official - Phone:713-799-1000
Mailing Address - Street 1:1311 PRINCE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-4924
Mailing Address - Country:US
Mailing Address - Phone:821-809-3600
Mailing Address - Fax:713-799-1260
Practice Address - Street 1:8906 WALL ST STE 608
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-4545
Practice Address - Country:US
Practice Address - Phone:713-397-9558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty