MEDICARE: ATLAS PROSTHETICS & ORTHOTICS, PLLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101822	OTHER	TX	TDLR

General Provider Information

NPI Number	:	1578422648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS PROSTHETICS & ORTHOTICS, PLLC

Provider Business Mailing Address
First Line	:	3129 KINGSLEY DR STE 1620
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8510
Country	:	US
Telephone Number	:	281-781-2751
Fax Number	:	281-602-3451

Provider Business Practice Location Address
First Line	:	4110 NORTH ST
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1817
Country	:	US
Telephone Number	:	936-559-1881
Fax Number	:	936-569-1890

Authorized Official
Title or Position	:	OWNER/CLINCIAN
Name	:	LEE A JONES II
Credential	:	CPO, LPO
Telephone Number	:	281-781-2751

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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