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General NPI Number Information
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NPI Number | 1063168326
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Entity Type | Individual
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Provider Name | FAHAD ASLAM D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | ACADEMY FOOT & ANKLE SPECIALISTS 1940 E. STATE HWY 114, SUITE 150
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6526
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Country | US
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Telephone | 817-424-3668
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Fax | 817-442-8637
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Provider Business Mailing Address
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Address Line | 1940 E. STATE HWY 114 SUITE 150
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6526
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Country | US
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Telephone | 817-424-3668
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Fax | 817-442-8637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SC007186
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 692108
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License Number State | TX
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