Healthcare Provider Details

I. General information

NPI: 1801483045
Provider Name (Legal Business Name): PRIME FOOT AND ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2020
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

Practice location:
  • Phone: 817-704-4223
  • Fax:
Mailing address:
  • Phone: 404-200-6366
  • 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: DR. AMYN LAKHANI
Title or Position: PODIATRIST
Credential: DPM
Phone: 404-200-6366