Healthcare Provider Details

I. General information

NPI: 1568665438
Provider Name (Legal Business Name): ASHTON PODIATRY ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11613 N CENTRAL EXPWY #121
DALLAS TX
75243-3842
US

IV. Provider business mailing address

11613 N CENTRAL EXPWY #121
DALLAS TX
75243-3820
US

V. Phone/Fax

Practice location:
  • Phone: 214-691-0760
  • Fax: 214-691-5434
Mailing address:
  • Phone: 214-691-0760
  • Fax: 214-691-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0676
License Number StateTX

VIII. Authorized Official

Name: ROY W. ASHTON
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 214-691-0760