| Advanced Foot And Ankle Associates Pllc | |
|
6312 Azle Ave, Lake Worth, TX 76135-2442 | |
| (817) 238-8400 | |
| (817) 238-8401 |
| Full Name | Advanced Foot And Ankle Associates Pllc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 6312 Azle Ave, Lake Worth, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568783553 | NPI | - | NPPES |
| 0029WA | Other | TX | BCBS TX |
| 218408702 | Medicaid | TX | |
| 218408703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 1916 (Texas) | Primary |
| Provider Name | Russell Olin Pendleton |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932356789 PECOS PAC ID: 8022141662 Enrollment ID: I20100803000201 |
| Provider Name | Mark William Thompson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750733119 PECOS PAC ID: 0547558728 Enrollment ID: I20190802000988 |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Foot And Ankle Associates Pllc 6312 Azle Ave, Lake Worth, TX 76135-2442 Ph: (817) 238-8400 | Advanced Foot And Ankle Associates Pllc 6312 Azle Ave, Lake Worth, TX 76135-2442 Ph: (817) 238-8400 |
Mark Thompson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6312 Azle Ave, Lake Worth, TX 76135 Phone: 817-238-8400 Fax: 817-238-8401 | |
Dr. Russell Pendleton, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6312 Azle Ave, Lake Worth, TX 76135 Phone: 817-238-8400 Fax: 817-238-8401 |