Organization
EMBRACE DIABETES FOOTWEAR SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODDY JACK (CEO)
(817) 994-0543
Entity
Organization
Contact information
Practice address
982 N COOPER ST, ARLINGTON, TX 76011-5779
(817) 994-0543
Mailing address
982 N COOPER ST, ARLINGTON, TX 76011-5779
(817) 994-0543
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
651515165
MULTIPLE LICENSE STATE OF TEXAS
TX
Enumeration date
12/23/2010
Last updated
12/23/2010
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