MEDICARE: LARRY L STRICKLAND JR DPM PC

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	213E00000X	Podiatrist	1313	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1315270001	OTHER	TX	DEMERC

General Provider Information

NPI Number	:	1750375382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY L STRICKLAND JR DPM PC

Provider Business Mailing Address
First Line	:	4230 N I-35
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76207-3408
Country	:	US
Telephone Number	:	940-566-3838
Fax Number	:	940-382-6393

Provider Business Practice Location Address
First Line	:	4230 N I-35
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76207-3408
Country	:	US
Telephone Number	:	940-566-3838
Fax Number	:	940-382-6393

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. LARRY LEE STRICKLAND JR.
Credential	:	DPM
Telephone Number	:	940-566-3838

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	08/22/2020

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