Provider Demographics
NPI:1700852274
Name:JOHN S. SCIORTINO, D.P.M., P.A.
Entity Type:Organization
Organization Name:JOHN S. SCIORTINO, D.P.M., P.A.
Other - Org Name:NORTH TEXAS FOOT CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SCIORTINO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:903-893-9661
Mailing Address - Street 1:3415 LOY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-1744
Mailing Address - Country:US
Mailing Address - Phone:903-893-9661
Mailing Address - Fax:903-868-2975
Practice Address - Street 1:3415 LOY LAKE RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1744
Practice Address - Country:US
Practice Address - Phone:903-893-9661
Practice Address - Fax:903-868-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0817213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084925901Medicaid
TX4264580001Medicare NSC
TX00R84WMedicare PIN