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NPI Code Detail

MEDICARE: DALLAS PODIATRY WORKS PA

MEDICARE: DALLAS PODIATRY WORKS PA
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
1213ES0103XFoot & Ankle Surgery Podiatrist1345TX

General Provider Information

NPI Number : 1497899827
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS PODIATRY WORKS PA
Provider Business Mailing Address
First Line : 7777 FOREST LN
Second Line : STE A212
City : DALLAS
State : TX
Zip : 75230-2505
Country : US
Telephone Number : 972-566-7474
Fax Number : 972-566-7479
Provider Business Practice Location Address
First Line : 7777 FOREST LN
Second Line : A212
City : DALLAS
State : TX
Zip : 75230-2535
Country : US
Telephone Number : 972-566-7474
Fax Number : 972-566-7479
Authorized Official
Title or Position : PRESIDENT
Name : JOEL W BROOK
Credential : D.P.M.
Telephone Number : 972-566-7474
Provider Enumeration Date : 02/18/2007
Last Update Date : 02/03/2011

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Directions to “DALLAS PODIATRY WORKS PA ” Practice Location

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