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General NPI Number Information
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NPI Number | 1003844176
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE ASSOCIATES OF NORTH TEXAS, LLP
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 2421 IRA E WOODS AVE STE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3906
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Country | US
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Telephone | 817-416-6155
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Fax | 817-329-9434
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Provider Business Mailing Address
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Address Line | 2421 IRA E WOODS AVE STE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-3906
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Country | US
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Telephone | 817-416-6155
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Fax | 817-329-9434
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | LORI CERAMI
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Credential |
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Telephone | 817-796-3245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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