Provider Demographics
NPI:1134328057
Name:NORTH STAR FOOT AND ANKLE ASSOCIATES, PA
Entity Type:Organization
Organization Name:NORTH STAR FOOT AND ANKLE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-480-0072
Mailing Address - Street 1:3600 NORTHSTAR RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-5308
Mailing Address - Country:US
Mailing Address - Phone:972-480-0072
Mailing Address - Fax:972-480-0073
Practice Address - Street 1:6550 NAAMAN FOREST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-5691
Practice Address - Country:US
Practice Address - Phone:972-480-0072
Practice Address - Fax:972-480-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1760213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6133210001Medicare NSC
TX8F21946Medicare PIN