| |
6257 Fm 2642 Blvd Ste 102, Royse City, TX 75189-3229 | |
(972) 412-4449 | |
(972) 412-6460 |
Full Name | |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot & Ankle Surgery |
Location | 6257 Fm 2642 Blvd Ste 102, Royse City, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023673498 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8135 Forest Ln # 515057, Dallas, TX 75230-2472 Ph: (469) 850-5760 | 6257 Fm 2642 Blvd Ste 102, Royse City, TX 75189-3229 Ph: (972) 412-4449 |