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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