MEDICARE: PATHWAY FOOT & ANKLE CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1144000167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY FOOT & ANKLE CENTER, PLLC

Provider Business Mailing Address
First Line	:	3100 SAM RAYBURN HWY
Second Line	:
City	:	MELISSA
State	:	TX
Zip	:	75454-2663
Country	:	US
Telephone Number	:	469-823-1505
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 SAM RAYBURN HWY
Second Line	:
City	:	MELISSA
State	:	TX
Zip	:	75454-2663
Country	:	US
Telephone Number	:	469-823-1505
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER M SMITH
Credential	:	DPM
Telephone Number	:	469-215-2366

Provider Enumeration Date	:	10/05/2023
Last Update Date	:	03/07/2024

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