Provider Demographics
NPI:1245303486
Name:DASHE ORTHOPEDIC SUPPLIES INC
Entity type:Organization
Organization Name:DASHE ORTHOPEDIC SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-371-1700
Mailing Address - Street 1:8800 SHOAL CREEK BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-6818
Mailing Address - Country:US
Mailing Address - Phone:512-371-1700
Mailing Address - Fax:512-371-1754
Practice Address - Street 1:5445 LA SIERRA DR
Practice Address - Street 2:SUITE 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4139
Practice Address - Country:US
Practice Address - Phone:972-705-9090
Practice Address - Fax:970-705-9099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSI PREMIER SPECIALTIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-16
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00427999335E00000X
TX0042799332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1311770001Medicare NSC