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General NPI Number Information
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NPI Number | 1992974182
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Entity Type | Organization
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Legal Business Name | DIESEL PROSTHETICS AND ORTHOTICS, INC.
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 1411 W HOUSTON ST
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City | SHERMAN
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State | TX
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Zip | 75092-7409
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Country | US
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Telephone | 903-891-0230
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Fax | 903-891-8743
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Provider Business Mailing Address
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Address Line | 1411 W HOUSTON ST
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City | SHERMAN
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State | TX
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Zip | 75092-7409
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Country | US
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Telephone | 903-891-0230
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Fax | 903-891-8743
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS LEE DIESEL
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Credential | CPO, LPO
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Telephone | 903-891-0230
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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 | 255
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 255
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License Number State | TX
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