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General NPI Number Information
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NPI Number | 1821744350
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Entity Type | Organization
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Legal Business Name | DFW FOOT AND ANKLE CARE LLC
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 2910 BROADWAY BLVD STE 212
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City | GARLAND
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State | TX
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Zip | 75041-3794
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Country | US
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Telephone | 469-551-8595
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Fax |
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Provider Business Mailing Address
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Address Line | 9720 COIT RD STE 220-224
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City | PLANO
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State | TX
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Zip | 75025-5833
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Country | US
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Telephone | 469-551-8595
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZUBEEN MISTRY
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Credential | DPM
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Telephone | 469-551-8595
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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 |
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License Number State | NULL
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