MEDICARE: APPLE PODIATRY GROUP, P.A.

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	0408	TX

General Provider Information

NPI Number	:	1891952123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLE PODIATRY GROUP, P.A.

Provider Business Mailing Address
First Line	:	3600 MATLOCK RD
Second Line	:	SUITE 104
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3679
Country	:	US
Telephone Number	:	817-460-1300
Fax Number	:	817-460-1307

Provider Business Practice Location Address
First Line	:	3600 MATLOCK RD
Second Line	:	SUITE 104
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3679
Country	:	US
Telephone Number	:	817-460-1300
Fax Number	:	817-460-1307

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NORMAN WILLIAM GOLDMAN
Credential	:	D.P.M.
Telephone Number	:	817-460-1300

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	10/21/2014

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