Provider Demographics
NPI:1447386271
Name:METROPLEX FOOT AND ANKLE, LLP
Entity Type:Organization
Organization Name:METROPLEX FOOT AND ANKLE, LLP
Other - Org Name:PODIATRIC SURGICAL ASSOCIATES OF NORTH TEXAS, LLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIGAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-217-3668
Mailing Address - Street 1:3201 E PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3566
Mailing Address - Country:US
Mailing Address - Phone:214-217-3668
Mailing Address - Fax:214-217-3669
Practice Address - Street 1:3201 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3566
Practice Address - Country:US
Practice Address - Phone:214-217-3668
Practice Address - Fax:214-217-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1080213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00173NMedicare PIN
TX4173070001Medicare NSC
CK2083Medicare PIN