MEDICARE: FOOT AND ANKLE CENTER OF WEST TEXAS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	1704	TX

General Provider Information

NPI Number	:	1619903184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT AND ANKLE CENTER OF WEST TEXAS PA

Provider Business Mailing Address
First Line	:	705 W WADLEY AVE STE 200
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79705-5370
Country	:	US
Telephone Number	:	432-682-0222
Fax Number	:	324-682-0242

Provider Business Practice Location Address
First Line	:	705 W WADLEY AVE STE 200
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79705-5370
Country	:	US
Telephone Number	:	432-682-0222
Fax Number	:	432-682-0242

Authorized Official
Title or Position	:	PODIATRIST/OWNER
Name	:	BRIAN MIDDLEBROOK
Credential	:	DPM
Telephone Number	:	432-682-0222

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	05/20/2024

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Directions to “FOOT AND ANKLE CENTER OF WEST TEXAS PA ” Practice Location

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