Provider Demographics
NPI:1932877198
Name:TITAN PROSTHETICS INC
Entity Type:Organization
Organization Name:TITAN PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:HENNIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-925-6556
Mailing Address - Street 1:600 LEMENS AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-3484
Mailing Address - Country:US
Mailing Address - Phone:512-925-6556
Mailing Address - Fax:888-482-6534
Practice Address - Street 1:3911 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-1035
Practice Address - Country:US
Practice Address - Phone:888-482-6534
Practice Address - Fax:888-482-6534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier