MEDICARE: DALLAS FOOT AND ANKLE SPECIALISTS,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	213ES0103X	Foot & Ankle Surgery Podiatrist	1568	TX

General Provider Information

NPI Number	:	1851562649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS FOOT AND ANKLE SPECIALISTS,PA

Provider Business Mailing Address
First Line	:	3600 GASTON AVE STE 402
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1804
Country	:	US
Telephone Number	:	214-832-4710
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 GASTON AVE STE 402
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1804
Country	:	US
Telephone Number	:	214-832-4710
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PETER BRIAN WOOD
Credential	:	DPM
Telephone Number	:	214-824-7100

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	04/08/2014

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