Organization
HEDGECOCK ARTIFICIAL LIMB CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN CICERO (CHAIRMAN OF BOARD/PRESIDENT)
(214) 360-9700
Entity
Organization
Contact information
Practice address
6500 GREENVILLE AVE, STE 195, DALLAS, TX 75206-1014
(214) 360-9700
(214) 360-9713
Mailing address
6500 GREENVILLE AVE, STE 195, DALLAS, TX 75206-1014
(214) 360-9700
(214) 360-9713
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
000050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000500051
BLUE CROSS BLUE SHIELD
TX
05
—
0861296-01
—
TX
Enumeration date
10/17/2006
Last updated
03/24/2010
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