Healthcare Provider Details

I. General information

NPI: 1558857250
Provider Name (Legal Business Name): FOOT & ANKLE CONSULTANTS OF TEXAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 VILLAGE DR STE 300
MURPHY TX
75094-4634
US

IV. Provider business mailing address

412 VILLAGE DR STE 300
MURPHY TX
75094-4634
US

V. Phone/Fax

Practice location:
  • Phone: 972-881-0110
  • Fax: 972-633-3721
Mailing address:
  • Phone: 972-427-3228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2344
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number2344
License Number StateTX

VIII. Authorized Official

Name: DR. MARCUS ALLEN BAXTER
Title or Position: OWNER/ PODIATRIC SURGEON
Credential: DPM
Phone: 972-881-0110