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General NPI Number Information
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NPI Number | 1881695278
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Entity Type | Individual
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Provider Name | CHARLEEN MARIE HANDZEL D.P.M
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 03/16/2013
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Provider Practice Location Address
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Address Line | 1422 MAIN ST SUITE 249
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7625
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Country | US
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Telephone | 817-329-0013
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Fax | 817-410-1412
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Provider Business Mailing Address
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Address Line | 821 PAISLEY DR
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City | FLOWER MOUND
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State | TX
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Zip | 75028-7209
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Country | US
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Telephone | 972-814-2427
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Fax | 972-691-7921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1434
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License Number State | TX
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