Provider Demographics
NPI:1568665438
Name:ASHTON PODIATRY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ASHTON PODIATRY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:W
Authorized Official - Last Name:ASHTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-691-0760
Mailing Address - Street 1:11613 N CENTRAL EXPWY
Mailing Address - Street 2:#121
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3820
Mailing Address - Country:US
Mailing Address - Phone:214-691-0760
Mailing Address - Fax:214-691-5434
Practice Address - Street 1:11613 N CENTRAL EXPWY
Practice Address - Street 2:#121
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3842
Practice Address - Country:US
Practice Address - Phone:214-691-0760
Practice Address - Fax:214-691-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0676213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N43JMedicare PIN
TX0474170003Medicare NSC