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General NPI Number Information
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NPI Number | 1336220607
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Entity Type | Organization
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Legal Business Name | HEDGECOCK ARTIFICIAL LIMB CO., INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 6500 GREENVILLE AVE STE 195
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City | DALLAS
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State | TX
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Zip | 75206-1014
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Country | US
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Telephone | 214-360-9700
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Fax | 214-360-9713
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Provider Business Mailing Address
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Address Line | 6500 GREENVILLE AVE STE 195
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City | DALLAS
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State | TX
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Zip | 75206-1014
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Country | US
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Telephone | 214-360-9700
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Fax | 214-360-9713
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Authorized Official
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Title or Position | CHAIRMAN OF BOARD/PRESIDENT
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Name | ANN CICERO
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Credential |
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Telephone | 214-360-9700
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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 | 000050
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License Number State | TX
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