Provider Demographics
NPI:1053627273
Name:NORTH TEXAS FOOT AND ANKLE SPECIALISTS
Entity Type:Organization
Organization Name:NORTH TEXAS FOOT AND ANKLE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TU
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-585-3642
Mailing Address - Street 1:102 N LOCUST ST # 102
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-382-8801
Mailing Address - Fax:940-382-8805
Practice Address - Street 1:102 N LOCUST ST # 102
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-382-8801
Practice Address - Fax:940-382-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1846261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6465020001Medicare NSC