MEDICARE: ADVANCED PROSTHETIC RESEARCH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	101432	TX

General Provider Information

NPI Number	:	1154662864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PROSTHETIC RESEARCH INC

Provider Business Mailing Address
First Line	:	7700 SAN JACINTO PL
Second Line	:	STE 300
City	:	PLANO
State	:	TX
Zip	:	75024-3254
Country	:	US
Telephone Number	:	469-241-1477
Fax Number	:	469-241-1433

Provider Business Practice Location Address
First Line	:	7700 SAN JACINTO PL
Second Line	:	STE 300
City	:	PLANO
State	:	TX
Zip	:	75024-3254
Country	:	US
Telephone Number	:	469-241-1477
Fax Number	:	469-241-1433

Authorized Official
Title or Position	:	OWNER/PRACTITIONER IN CHARGE
Name	:	JAN MORGAN GAINER
Credential	:	LP
Telephone Number	:	469-241-1477

Provider Enumeration Date	:	03/05/2013
Last Update Date	:	04/09/2013

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