Provider Demographics
NPI:1225407489
Name:ATX FOOT & ANKLE PLLC
Entity Type:Organization
Organization Name:ATX FOOT & ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:405-205-5966
Mailing Address - Street 1:3100 ESPERANZA XING
Mailing Address - Street 2:#6407
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3769
Mailing Address - Country:US
Mailing Address - Phone:405-205-5966
Mailing Address - Fax:
Practice Address - Street 1:9012 RESEARCH BLVD
Practice Address - Street 2:SUITE C-13
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7093
Practice Address - Country:US
Practice Address - Phone:405-205-5966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2170213ES0103X
TX2171213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty