Provider Demographics
NPI:1871596270
Name:ADVANCED ARM DYNAMICS OF TEXAS, LLC
Entity type:Organization
Organization Name:ADVANCED ARM DYNAMICS OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGUELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CP, FAAOP (D)
Authorized Official - Phone:310-372-3050
Mailing Address - Street 1:123 W TORRANCE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3610
Mailing Address - Country:US
Mailing Address - Phone:310-372-3050
Mailing Address - Fax:310-372-3057
Practice Address - Street 1:3501 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 650
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3636
Practice Address - Country:US
Practice Address - Phone:214-260-3197
Practice Address - Fax:214-260-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX554860000225XH1200X
TX000119335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101220OtherSTATE FACILITY LICENSE
TX554860000OtherOCCUPATIONAL THERAPY
TX101220OtherSTATE FACILITY LICENSE