| Academy Foot & Ankle Specialists | |
|
1940 Highway 114, Ste 150, Southlake, TX 76092-6526 | |
| (817) 424-3668 | |
| (817) 442-8637 |
| Full Name | Academy Foot & Ankle Specialists |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 1940 Highway 114, Southlake, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356541346 | NPI | - | NPPES |
| 1356541346 | Other | TX | GROUP NPI |
| U66467 | Other | TX | DR. MARCIANO'S UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 1364 (Texas) | Primary |
| Provider Name | Paul T Marciano |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558321810 PECOS PAC ID: 6002881554 Enrollment ID: I20041104001200 |
| Provider Name | Larissa Rolim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144678517 PECOS PAC ID: 3072893569 Enrollment ID: I20161129000087 |
| Provider Name | Scott B Floyd |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508249558 PECOS PAC ID: 0446508675 Enrollment ID: I20180806000403 |
| Provider Name | Dorian Louis Jimenez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952397119 PECOS PAC ID: 3274565866 Enrollment ID: I20190827003605 |
| Provider Name | Sirisha Viswapriya Pokala |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407345721 PECOS PAC ID: 1355696832 Enrollment ID: I20210712000248 |
| Provider Name | Brett M Nielsen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285216853 PECOS PAC ID: 7012311996 Enrollment ID: I20210816000218 |
| Mailing Address | Practice Location Address |
|---|---|
| Academy Foot & Ankle Specialists 1940 E State Hwy 114, Suite 150, Southlake, TX 76092-6526 Ph: (817) 424-3668 | Academy Foot & Ankle Specialists 1940 Highway 114, Ste 150, Southlake, TX 76092-6526 Ph: (817) 424-3668 |
Dr. Greg Jack Amelung, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1940 E Highway 114 Ste 150, Southlake, TX 76092 Phone: 817-503-0009 Fax: 817-503-8909 | |
Paul Thomas Marciano, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1940 E State Highway 114, Suite 150, Southlake, TX 76092 Phone: 817-424-3668 Fax: 817-442-8637 | |
Charleen Marie Handzel, D.P.M Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1422 Main St, Suite 249, Southlake, TX 76092 Phone: 817-329-0013 Fax: 817-410-1412 | |
Southlake Family Foot Center Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1422 Main St, Ste 249, Southlake, TX 76092 Phone: 817-329-0013 Fax: 817-410-1412 | |
Dorian Louis Jimenez, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1940 Hwy 114 Suite 150, Southlake, TX 76092 Phone: 817-424-3668 Fax: 817-442-8637 | |
Brady Mallory, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1940 East Hwy 114 Suite 150, Southlake, TX 76092 Phone: 817-424-3668 Fax: 817-442-8637 |