Healthcare Provider Details

I. General information

NPI: 1528665437
Provider Name (Legal Business Name): NEW HORIZON FOOT AND ANKLE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2020
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 OSLER DR STE 150
ARLINGTON TX
76010-5407
US

IV. Provider business mailing address

PO BOX 210773
BEDFORD TX
76095-7773
US

V. Phone/Fax

Practice location:
  • Phone: 817-538-5291
  • Fax:
Mailing address:
  • Phone: 817-330-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: NDIDI UFONDU
Title or Position: DIRECTOR
Credential:
Phone: 817-538-5291