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General NPI Number Information
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NPI Number | 1720530017
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Entity Type | Organization
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Legal Business Name | KRL FOOT & ANKLE PC
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1428 W HEBRON PKWY 130
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City | CARROLLTON
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State | TX
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Zip | 75010-6345
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Country | US
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Telephone | 972-325-1955
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 W HEBRON PKWY 130
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City | CARROLLTON
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State | TX
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Zip | 75010-6345
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Country | US
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Telephone | 972-325-1955
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Fax | 972-805-4541
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. KELLY RENEE LAWLER
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Credential | DPM
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Telephone | 815-298-4033
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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 | 2042
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License Number State | TX
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