Organization
WACO PROSTHETICS, INC.
Active
Organization
WACO PROSTHETICS, INC.
Active
Other names
Innovative Prosthetics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA WILLIAMS (PRESIDENT AND CEO)
(469) 400-4363
Entity
Organization
Contact information
Practice address
201 COLONNADE PKWY STE 101, WACO, TX 76712-6174
(254) 652-4898
(866) 981-5223
Mailing address
201 COLONNADE PKWY STE 101, WACO, TX 76712-6174
(254) 652-4898
(866) 981-5223
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
101602
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101602
TEXAS DEPARTMENT OF LICENSING AND REGULATION
TX
Enumeration date
04/27/2018
Last updated
04/27/2018
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