Titan Prosthetics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

TITAN PROSTHETICS INC

Practice address

3911 Southern Ave
Shreveport, LA 71106-1035

Phone

(888) 482-6534

Fax

(888) 482-6534

NPI assigned

Sep 2, 2021

Organization subpart

No

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

Authorized official

Name

Drew C Hennig

Title

Cfo

Phone

(512) 925-6556

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1932877198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 LEMENS AVE STE 700",
            "city": "HUTTO",
            "state": "TX",
            "postal_code": "786343484",
            "telephone_number": "512-925-6556",
            "fax_number": "888-482-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 SOUTHERN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711061035",
            "telephone_number": "888-482-6534",
            "fax_number": "888-482-6534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 State St",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396483938",
            "country_code": "US",
            "telephone_number": "888-482-6534",
            "fax_number": "888-482-6534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TITAN PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "HENNIG",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "512-925-6556"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Tisby, M. DIV.
• Samaria Randle Tisby
• Anthony Tisdale
• Charles Girard Tisdale, PA-C
• James Nicholas Tisdell, PHARMD
• TLM Diagnostics LLC
• TM Smith MD LLC
• John Rucker Todd IV, M.D.
• London Claire Todd, MD
• Piper Todd

• Prosthetic/Orthotic Supplier in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Prosthetic/Orthotic Supplier in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.