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General NPI Number Information
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NPI Number | 1558857250
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Entity Type | Organization
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Legal Business Name | FOOT & ANKLE CONSULTANTS OF TEXAS, LLC
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 412 VILLAGE DR STE 300
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City | MURPHY
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State | TX
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Zip | 75094-4634
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Country | US
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Telephone | 972-881-0110
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Fax | 972-633-3721
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Provider Business Mailing Address
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Address Line | 412 VILLAGE DR STE 300
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City | MURPHY
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State | TX
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Zip | 75094-4634
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Country | US
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Telephone | 972-427-3228
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Fax |
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Authorized Official
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Title or Position | OWNER/ PODIATRIC SURGEON
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Name | DR. MARCUS ALLEN BAXTER
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Credential | DPM
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Telephone | 972-881-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | 2344
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2344
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License Number State | TX
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