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General NPI Number Information
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NPI Number | 1689180564
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Entity Type | Organization
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Legal Business Name | AMNIOTIC SURGICAL INNOVATIONS, INC
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 12/14/2017
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Provider Practice Location Address
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Address Line | 777 N GROVE RD STE 115
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City | RICHARDSON
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State | TX
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Zip | 75081-2760
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Country | US
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Telephone | 214-663-2821
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Fax | 214-466-1199
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Provider Business Mailing Address
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Address Line | 777 N GROVE RD STE 115
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City | RICHARDSON
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State | TX
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Zip | 75081-2760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRETT CARROLL
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Credential |
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Telephone | 214-663-2821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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