Provider Demographics
NPI:1518920586
Name:ACCESSIBLE FOOT CARE INC.
Entity Type:Organization
Organization Name:ACCESSIBLE FOOT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-298-8100
Mailing Address - Street 1:777 E WHEATLAND RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4918
Mailing Address - Country:US
Mailing Address - Phone:972-298-8100
Mailing Address - Fax:972-780-0798
Practice Address - Street 1:777 E WHEATLAND RD
Practice Address - Street 2:SUITE 107
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4918
Practice Address - Country:US
Practice Address - Phone:972-298-8100
Practice Address - Fax:972-780-0798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0921213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167649601Medicaid
TX00299UMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
TX167649601Medicaid