Healthcare Provider Details

I. General information

NPI: 1447632724
Provider Name (Legal Business Name): ASHLEY MICHELLE VARNER D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 03/27/2021
Certification Date: 03/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 W PIONEER PKWY STE 200
ARLINGTON TX
76013
US

IV. Provider business mailing address

1108 W PIONEER PKWY STE 200
ARLINGTON TX
76013
US

V. Phone/Fax

Practice location:
  • Phone: 817-704-4223
  • Fax: 817-984-3970
Mailing address:
  • Phone: 817-704-4223
  • Fax: 817-984-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901002581
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2308
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: