| NPI | 1194978833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE STUART LEE SHEEN Owner 281-580-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 1) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2019-02-18 |