Healthcare Provider Details

I. General information

NPI: 1942323175
Provider Name (Legal Business Name): NORTH TEXAS PODIATRY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 WESTPARK WAY
EULESS TX
76040-3957
US

IV. Provider business mailing address

401 WESTPARK WAY
EULESS TX
76040-3957
US

V. Phone/Fax

Practice location:
  • Phone: 817-283-5151
  • Fax: 817-283-8360
Mailing address:
  • Phone: 817-283-5151
  • Fax: 817-283-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberTX1421
License Number StateTX

VIII. Authorized Official

Name: DR. JEFFREY PATRICK TAYLOR
Title or Position: OWNER
Credential: D.P.M.
Phone: 817-283-5151