Healthcare Provider Details

I. General information

NPI: 1871596270
Provider Name (Legal Business Name): ADVANCED ARM DYNAMICS OF TEXAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N MACARTHUR BLVD SUITE 650
IRVING TX
75062-3636
US

IV. Provider business mailing address

123 W TORRANCE BLVD SUITE 203
REDONDO BEACH CA
90277-3610
US

V. Phone/Fax

Practice location:
  • Phone: 214-260-3197
  • Fax: 214-260-8602
Mailing address:
  • Phone: 310-372-3050
  • Fax: 310-372-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number000119
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number554860000
License Number StateTX

VIII. Authorized Official

Name: MR. JOHN MIGUELEZ
Title or Position: PRESIDENT
Credential: CP, FAAOP (D)
Phone: 310-372-3050