=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437635398
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL THOMAS PIERINI D.P.M.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2018
-----------------------------------------------------
Last Update Date | 03/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | ACADEMY FOOT & ANKLE SPECIALISTS 1940 E. STATE HWY 114, SUITE 150
-----------------------------------------------------
City | SOUTHLAKE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76092-6526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-424-3668
-----------------------------------------------------
Fax | 817-442-8637
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1940 E. STATE HWY 114 SUITE 150
-----------------------------------------------------
City | SOUTHLAKE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76092-6526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-424-3668
-----------------------------------------------------
Fax | 817-442-8637
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | SC006946
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 3085
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------