Provider Demographics
NPI:1770590895
Name:RUPLEY ARTIFICIAL LIMB CO.
Entity type:Organization
Organization Name:RUPLEY ARTIFICIAL LIMB CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:817-536-7367
Mailing Address - Street 1:3122 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76103-2928
Mailing Address - Country:US
Mailing Address - Phone:817-536-7367
Mailing Address - Fax:817-536-5397
Practice Address - Street 1:3122 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-2928
Practice Address - Country:US
Practice Address - Phone:817-536-7367
Practice Address - Fax:817-536-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000112291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0344160001Medicare ID - Type Unspecified