MEDICARE: ADVANCED ARM DYNAMICS OF HOUSTON LLC

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	225XH1200X	Hand Occupational Therapist
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	66	OTHER	TX	STATE LICENCE

General Provider Information

NPI Number	:	1952708588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ARM DYNAMICS OF HOUSTON LLC

Provider Business Mailing Address
First Line	:	123 W TORRANCE BLVD STE 203
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3614
Country	:	US
Telephone Number	:	310-372-3050
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BINZ ST STE 630
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6944
Country	:	US
Telephone Number	:	310-372-3050
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN M MIGUELEZ
Credential	:	CP, FAAOP
Telephone Number	:	310-372-3050

Provider Enumeration Date	:	11/25/2014
Last Update Date	:	01/16/2025

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