Healthcare Provider Details

I. General information

NPI: 1871625525
Provider Name (Legal Business Name): CARLA J. EMERY, DPM, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 NORTHLAND DR SUITE 308
AUSTIN TX
78731-4945
US

IV. Provider business mailing address

3303 NORTHLAND DR SUITE 308
AUSTIN TX
78731-4945
US

V. Phone/Fax

Practice location:
  • Phone: 512-420-0808
  • Fax: 512-420-0969
Mailing address:
  • Phone: 512-420-0808
  • Fax: 512-420-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0758
License Number StateTX

VIII. Authorized Official

Name: DR. CARLA J EMERY
Title or Position: PHYSICIAN OWNER
Credential: DPM PA
Phone: 512-420-0808