Gaston Avenue Prosthetics, LLC

NPI #1245214568 in Dallas, Texas

Provider Information

NPI Number
1245214568
Entity Type
Organization
Organization Name
Gaston Avenue Prosthetics, LLC
Primary Specialty
Prosthetic/Orthotic Supplier
Enumeration Date
Nov 30, 2005
Last Updated
Jan 30, 2012

Practice Location

Address
9900 N CENTRAL EXPY
Address 2
#205
City
Dallas
State
Texas
ZIP Code
75231-4395
Phone
(214) 265-5060

Authorized Official

Name
MS. CATHERINE AMY MILLER-MEHARY, CP,LP,BOCO
Title
PRESIDENT
Phone
(214) 265-5060

Specialties & Taxonomy Codes

Specialty
Clinic/Center - AmputeeAmputee
Prosthetic/Orthotic Supplier

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