Healthcare Provider Details
I. General information
NPI: 1477875995
Provider Name (Legal Business Name): PODIATRIC MEDICAL PARTNERS OF TEXAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2010
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
504 N CARRIER PKWY
GRAND PRAIRIE TX
75050-5428
US
IV. Provider business mailing address
801 N ZANG BLVD STE 103
DALLAS TX
75208-4858
US
V. Phone/Fax
- Phone: 972-263-7042
- Fax: 321-256-2966
- Phone: 214-330-9299
- Fax: 866-846-5648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
GALPERIN
Title or Position: OWNER, PRESIDENT
Credential: DPM
Phone: 214-330-9299