Provider Demographics
NPI:1972355733
Name:TEXAS PROSTHETIC CLINICS ATX LLC
Entity Type:Organization
Organization Name:TEXAS PROSTHETIC CLINICS ATX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-704-9530
Mailing Address - Street 1:6448 E HIGHWAY 290 STE F110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1077
Mailing Address - Country:US
Mailing Address - Phone:512-566-0896
Mailing Address - Fax:512-566-0897
Practice Address - Street 1:6448 E HIGHWAY 290 STE F110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1077
Practice Address - Country:US
Practice Address - Phone:512-566-0896
Practice Address - Fax:512-566-0897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier