Provider Demographics
NPI:1457653446
Name:DFWC PC
Entity Type:Organization
Organization Name:DFWC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OM
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-321-4477
Mailing Address - Street 1:4600 HALE PKWY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4020
Mailing Address - Country:US
Mailing Address - Phone:303-321-4477
Mailing Address - Fax:303-321-5323
Practice Address - Street 1:4600 HALE PKWY
Practice Address - Street 2:SUITE 440
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4020
Practice Address - Country:US
Practice Address - Phone:303-321-4477
Practice Address - Fax:303-321-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO607213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty