Provider Demographics
NPI:1003815820
Name:ARNOLD, DOUGLAS HARRIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:HARRIS
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-6716
Mailing Address - Country:US
Mailing Address - Phone:940-465-1737
Mailing Address - Fax:
Practice Address - Street 1:116 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-6716
Practice Address - Country:US
Practice Address - Phone:940-465-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1535213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00482HMedicare ID - Type UnspecifiedPROVIDER NUMBER
T55576Medicare UPIN