Healthcare Provider Details
I. General information
NPI: 1265828123
Provider Name (Legal Business Name): AMYN LAKHANI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/07/2015
Last Update Date: 01/05/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1108 W PIONEER PKWY STE 200
ARLINGTON TX
76013-7627
US
IV. Provider business mailing address
2812 ORCHID ST
CARROLLTON TX
75007-5005
US
V. Phone/Fax
- Phone: 817-704-4223
- Fax:
- Phone: 404-200-6366
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | N006957 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 2360 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: