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General NPI Number Information
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NPI Number | 1154662864
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Entity Type | Organization
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Legal Business Name | ADVANCED PROSTHETIC RESEARCH INC
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 7700 SAN JACINTO PL STE 300
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City | PLANO
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State | TX
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Zip | 75024-3254
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Country | US
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Telephone | 469-241-1477
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Fax | 469-241-1433
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Provider Business Mailing Address
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Address Line | 7700 SAN JACINTO PL STE 300
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City | PLANO
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State | TX
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Zip | 75024-3254
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Country | US
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Telephone | 469-241-1477
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Fax | 469-241-1433
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Authorized Official
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Title or Position | OWNER/PRACTITIONER IN CHARGE
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Name | JAN MORGAN GAINER
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Credential | LP
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Telephone | 469-241-1477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 101432
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License Number State | TX
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