Healthcare Provider Details

I. General information

NPI: 1255683033
Provider Name (Legal Business Name): ACHILLES FOOT AND ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 OAK CREEK DR STE 120
AUSTIN TX
78727-3020
US

IV. Provider business mailing address

4131 DIRECTORS ROW
HOUSTON TX
77092-8703
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-7800
  • Fax: 512-244-7802
Mailing address:
  • Phone: 713-586-6778
  • Fax: 713-586-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY LAKEY
Title or Position: VP/REVENUE
Credential:
Phone: 713-586-6724