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General NPI Number Information
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NPI Number | 1285434605
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Entity Type | Organization
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Legal Business Name | DIVINE PROSTHETICS &ORTHOTICS-DPO- LLC
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 20320 NORTHWEST FWY STE 300
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City | JERSEY VILLAGE
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State | TX
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Zip | 77065-5643
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Country | US
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Telephone | 346-601-4545
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Fax | 346-601-4546
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Provider Business Mailing Address
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Address Line | 20320 NORTHWEST FWY STE 300
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City | JERSEY VILLAGE
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State | TX
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Zip | 77065-5643
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Country | US
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Telephone | 346-412-6701
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Fax | 346-601-4546
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Authorized Official
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Title or Position | CEO,CLINICAL DIRECTOR
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Name | MR. GIGI JOSEPH
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Credential | BOCPO,LPO
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Telephone | 346-412-6701
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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 |
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License Number State |
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