Custom Creations, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CUSTOM CREATIONS, LLC

Practice address

5701 President George Bush Hwy Ste 104
Rowlett, TX 75089-3691

Phone

(469) 897-5040

NPI assigned

Nov 14, 2024

Organization subpart

No

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

Authorized official

Name

Lynn GrantNPI 1720822109

Title

Owner

Phone

(469) 897-5040

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lynn Grant

  • Prosthetic/Orthotic Supplier
  • Rockwall, TX
  • NPI 1720822109
  NPD Authorized official

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1497579569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 N GOLIAD ST STE 102-817",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750877007",
            "telephone_number": "469-897-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 PRESIDENT GEORGE BUSH HWY STE 104",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750893691",
            "telephone_number": "469-897-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CREATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-897-5040"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Rowlett, TX
• Providers in Rowlett, 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 Nov 14, 2024; 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.