Provider Demographics
NPI: | 1861037418 |
---|---|
Name: | LEANDER FOOT & ANKLE PLLC |
Entity Type: | Organization |
Organization Name: | LEANDER FOOT & ANKLE PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | AFSHA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NAIMAT-SHAHZAD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPM |
Authorized Official - Phone: | 561-271-8838 |
Mailing Address - Street 1: | 1820 CRYSTAL FALLS PKWY STE 320 |
Mailing Address - Street 2: | |
Mailing Address - City: | LEANDER |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78641-3517 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-634-7419 |
Mailing Address - Fax: | 512-717-9071 |
Practice Address - Street 1: | 1820 CRYSTAL FALLS PKWY STE 320 |
Practice Address - Street 2: | |
Practice Address - City: | LEANDER |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78641-3517 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-634-7419 |
Practice Address - Fax: | 512-717-9071 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-11-07 |
Last Update Date: | 2020-03-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | Group - Single Specialty |