Provider Demographics
NPI:1265090690
Name:FREEDOM PROSTHETICS AND ORTHOTICS, INC.
Entity type:Organization
Organization Name:FREEDOM PROSTHETICS AND ORTHOTICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-580-8228
Mailing Address - Street 1:PO BOX 90939
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77290-0939
Mailing Address - Country:US
Mailing Address - Phone:281-580-8228
Mailing Address - Fax:281-580-8229
Practice Address - Street 1:138 1ST ST W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3619
Practice Address - Country:US
Practice Address - Phone:281-580-8228
Practice Address - Fax:281-580-8229
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREEDOM PROSTHETICS AND ORTHOTICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-31
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies