Provider Demographics
NPI:1821744350
Name:DFW FOOT AND ANKLE CARE LLC
Entity Type:Organization
Organization Name:DFW FOOT AND ANKLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZUBEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MISTRY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:469-551-8595
Mailing Address - Street 1:9720 COIT RD STE 220-224
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5833
Mailing Address - Country:US
Mailing Address - Phone:469-551-8595
Mailing Address - Fax:
Practice Address - Street 1:2910 BROADWAY BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3794
Practice Address - Country:US
Practice Address - Phone:469-551-8595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty