Provider Demographics
NPI:1841644051
Name:EXTRA SENSORY TECHNOLOGY
Entity type:Organization
Organization Name:EXTRA SENSORY TECHNOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL CORRESPONDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:O'GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-436-6749
Mailing Address - Street 1:9005 LODGE CT
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-6527
Mailing Address - Country:US
Mailing Address - Phone:512-436-6749
Mailing Address - Fax:
Practice Address - Street 1:9005 LODGE CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6527
Practice Address - Country:US
Practice Address - Phone:512-436-6749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies