Provider Demographics
NPI:1972591675
Name:ADVANCED ORTHOTICS & PROSTHETICS II INC
Entity type:Organization
Organization Name:ADVANCED ORTHOTICS & PROSTHETICS II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LP CPO BOCPO
Authorized Official - Phone:956-971-8200
Mailing Address - Street 1:2534 W TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8070
Mailing Address - Country:US
Mailing Address - Phone:956-971-8200
Mailing Address - Fax:956-928-0732
Practice Address - Street 1:2534 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8070
Practice Address - Country:US
Practice Address - Phone:956-971-8200
Practice Address - Fax:956-928-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530942OtherBCBS
TX530942OtherBCBS