Healthcare Provider Details

I. General information

NPI: 1194270579
Provider Name (Legal Business Name): TXFAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24022 CINCO VILLAGE CENTER BLVD SUITE 240
KATY TX
77494-8397
US

IV. Provider business mailing address

24022 CINCO VILLAGE CENTER BLVD SUITE 240
KATY TX
77494-8397
US

V. Phone/Fax

Practice location:
  • Phone: 832-376-8600
  • Fax: 832-376-8686
Mailing address:
  • Phone: 832-376-8600
  • Fax: 832-376-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2188
License Number StateTX

VIII. Authorized Official

Name: PHILLIP DAVID APPLEGATE JR.
Title or Position: PRESIDENT
Credential: DPM
Phone: 832-376-8600