=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861037418
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEANDER FOOT & ANKLE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2019
-----------------------------------------------------
Last Update Date | 03/06/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1820 CRYSTAL FALLS PKWY STE 320
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-3517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-634-7419
-----------------------------------------------------
Fax | 512-717-9071
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1820 CRYSTAL FALLS PKWY STE 320
-----------------------------------------------------
City | LEANDER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78641-3517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-634-7419
-----------------------------------------------------
Fax | 512-717-9071
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. AFSHA NAIMAT-SHAHZAD
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 561-271-8838
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------