Healthcare Provider Details

I. General information

NPI: 1245303486
Provider Name (Legal Business Name): DASHE ORTHOPEDIC SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 LA SIERRA DR SUITE 105
DALLAS TX
75231-4139
US

IV. Provider business mailing address

8800 SHOAL CREEK BLVD SUITE B
AUSTIN TX
78757-6818
US

V. Phone/Fax

Practice location:
  • Phone: 972-705-9090
  • Fax: 970-705-9099
Mailing address:
  • Phone: 512-371-1700
  • Fax: 512-371-1754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number00427999
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0042799
License Number StateTX

VIII. Authorized Official

Name: MR. JORGE BARRETT
Title or Position: CFO
Credential:
Phone: 512-371-1700