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General NPI Number Information
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NPI Number | 1437190816
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Entity Type | Organization
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Legal Business Name | ANDERSON FOOT CARE, P.A.
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 1765 BALLARD DR
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City | PARIS
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State | TX
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Zip | 75460-2879
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Country | US
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Telephone | 903-785-6100
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Fax | 903-785-6105
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Provider Business Mailing Address
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Address Line | 1765 BALLARD DR
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City | PARIS
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State | TX
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Zip | 75460-2879
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Country | US
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Telephone | 903-785-6100
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Fax | 903-785-6105
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHY IRENE ANDERSON
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Credential | DPM
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Telephone | 903-785-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 1603
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License Number State | TX
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