Provider Demographics
NPI:1497497457
Name:PODIATRY ASSOCIATES OF WEATHERFORD
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES OF WEATHERFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-939-2446
Mailing Address - Street 1:912 FOSTER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-8716
Mailing Address - Country:US
Mailing Address - Phone:817-800-8380
Mailing Address - Fax:
Practice Address - Street 1:912 FOSTER LN STE 100
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-8716
Practice Address - Country:US
Practice Address - Phone:817-800-8380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PODIATRY ASSOCIATES OF TEXAS.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty