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General NPI Number Information
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NPI Number | 1003467770
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Entity Type | Organization
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Legal Business Name | TOTAL FOOT AND ANKLE LLC
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 6300 W PARKER RD STE 425
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City | PLANO
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State | TX
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Zip | 75093-8104
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Country | US
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Telephone | 972-942-8080
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Fax | 972-759-9083
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Provider Business Mailing Address
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Address Line | 6300 W PARKER RD STE 425
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City | PLANO
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State | TX
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Zip | 75093-8104
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Country | US
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Telephone | 972-942-8080
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Fax | 972-759-9083
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | TAMMIE MARIE JACKSON
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Credential |
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Telephone | 214-676-9392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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