Provider Demographics
NPI:1083032924
Name:PODIATRIC MEDICAL PARTNERS OF TEXAS, PA
Entity Type:Organization
Organization Name:PODIATRIC MEDICAL PARTNERS OF TEXAS, PA
Other - Org Name:JONATHAN M KLETZ D P M P A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GALPERIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-330-9299
Mailing Address - Street 1:801 N ZANG BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4858
Mailing Address - Country:US
Mailing Address - Phone:214-330-9299
Mailing Address - Fax:866-846-5648
Practice Address - Street 1:514 E CORSICANA ST STE 3
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-2506
Practice Address - Country:US
Practice Address - Phone:214-340-8885
Practice Address - Fax:214-340-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty