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Gaston Avenue Prosthetics, Llc
Prosthetic/Orthotic Supplier in Dallas, Texas
NPI 1245214568

Gaston Avenue Prosthetics, Llc is a Prosthetic/Orthotic Supplier based in Dallas, TX. Gaston Avenue Prosthetics, Llc practices in Dallas, TX. The NPI Number for Gaston Avenue Prosthetics, Llc is 1245214568 and holds a License No. 101185 (Texas).

The current practice location address for Gaston Avenue Prosthetics, Llc is 9900 N Central Expy, Dallas, TX and can be reached out via phone at 214-265-5060 and via fax at 214-265-9055.

Location: 9900 N Central Expy, Dallas, TX, 75231-4395
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1245214568
Provider Name
Gaston Avenue Prosthetics, Llc
Credential
Provider Entity Type
Organization
Address
9900 N Central Expy, Dallas, TX, 75231-4395
Phone Number
214-265-5060
Fax Number
214-265-9055
Provider Enumeration Date
11/30/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
532218 01 TX BLUE CROSS BLUE SHIELD TX
1791246-01 05 TX
institution
Provider Business Practice Location Address Details
Address
9900 N Central Expy
City
Dallas
State
Texas
Zip
75231-4395
Phone Number
214-265-5060
Fax Number
214-265-9055
person
Provider Business Mailing Address Details
Address
9900 N Central Expy
City
Dallas
State
Texas
Zip
75231-4395
Phone Number
214-265-5060
Fax Number
214-265-9055
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Amputee
Taxonomy
261QA0900X
License No.
101185 (Texas)
Definition
An entity, facility, or distinct part of a facility providing counseling, fitting, custom design, prescriptive, and training services related to congenital or postoperative absence of all or part of a limb or limbs.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
101185 (Texas)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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