Provider Demographics
NPI:1336134469
Name:ORTHOTX, PLLC
Entity type:Organization
Organization Name:ORTHOTX, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLLIFRONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-375-5300
Mailing Address - Street 1:PO BOX 35232
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0630
Mailing Address - Country:US
Mailing Address - Phone:817-375-5200
Mailing Address - Fax:817-299-1708
Practice Address - Street 1:800 ORTHOPEDIC WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-1629
Practice Address - Country:US
Practice Address - Phone:817-375-5200
Practice Address - Fax:817-299-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085806001Medicaid
TX423444Medicare UPIN