Provider Demographics
NPI:1932401106
Name:ADVANCED ORTHOPEDIC DESIGNS, LLC
Entity Type:Organization
Organization Name:ADVANCED ORTHOPEDIC DESIGNS, LLC
Other - Org Name:TEXAS PROSTHETIC SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:503-407-5408
Mailing Address - Street 1:16250 KNOLL TRAIL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2866
Mailing Address - Country:US
Mailing Address - Phone:469-777-8771
Mailing Address - Fax:469-777-8776
Practice Address - Street 1:16250 KNOLL TRAIL DR STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2866
Practice Address - Country:US
Practice Address - Phone:469-777-8771
Practice Address - Fax:469-777-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier