Waco Prosthetics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

101602 Issued in TX

Legal business name

WACO PROSTHETICS, INC.

Doing business as

Innovative Prosthetics

Practice address

201 Colonnade Pkwy Ste 101
Waco, TX 76712-6174

Phone

(254) 652-4898

Fax

(866) 981-5223

NPI assigned

Apr 27, 2018

Last updated

Apr 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Williams

Title

President and Ceo

Phone

(469) 400-4363

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Innovative Prosthetics Doing business as

Locations

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1881182640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COLONNADE PKWY STE 101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126174",
            "telephone_number": "254-652-4898",
            "fax_number": "866-981-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 COLONNADE PKWY STE 101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126174",
            "telephone_number": "254-652-4898",
            "fax_number": "866-981-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "469-400-4363",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF LICENSING AND REGULATION",
            "identifier": "101602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Waco Partnership for Psychological and Spritual Care
• Waco Pathology Associates, P.a.
• Waco Pediatric Health Associates
• Waco PM&R Group, PA
• Waco Primary Care, P.a.
• Waco Psychological Associates
• Waco Radiology PA
• Waco Rheumatology PLLC
• Waco SN Opco LLC (Alpha Skilled Nursing & Rehab)
• Waco SNF LLC (Wesley Woods Health & Rehabilitation)

• 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 Apr 27, 2018; 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.