Provider Demographics
NPI:1437372323
Name:ORTHOTX, PLLC
Entity type:Organization
Organization Name:ORTHOTX, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLLIFRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-375-5200
Mailing Address - Street 1:PO BOX 35232
Mailing Address - Street 2:ATTN: CREDENTIALING
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:817-299-1789
Practice Address - Street 1:2716 TRAVIS DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2089
Practice Address - Country:US
Practice Address - Phone:817-375-5200
Practice Address - Fax:817-299-1789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDA6807OtherRAILROAD MEDICARE
TX0058KZOtherBLUE CROSS
TX5176840001Medicare NSC
TX00258WMedicare ID - Type UnspecifiedMEDICARE