Elite Prosthetics & Orthotics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

101117 Issued in TX

Legal business name

ELITE PROSTHETICS & ORTHOTICS INC

Practice address

2105 Franklin Ave
Waco, TX 76701

Phone

(254) 752-6352

Fax

(254) 714-2314

NPI assigned

Jan 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jon Emil Odling

Title

President

Phone

(254) 752-6352

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elite Prosthetics Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1003886003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 FRANKLIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76701",
            "telephone_number": "254-752-6352",
            "fax_number": "254-714-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FRANKLIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "76701",
            "telephone_number": "254-752-6352",
            "fax_number": "254-714-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PROSTHETICS & ORTHOTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "ODLING",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "EMIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-752-6352",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708059-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Ekoko, PHARMD
• Mohamed Aab El Ghawil, MBBS, MA, LPCC
• Devon Elder, PA-C
• Eyitemi Elete
• Marc Spencer Elieson, MD
• Elite Prosthetics, Inc.
• Elite Sports Medicine Physical Therapy
• Elite Therapy Services, LLC
• Amy Coyle Elliott, PA
• Cassidy Ellis, OT

• Prosthetic/Orthotic Supplier in Waco, TX
• Providers in Waco, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.