Provider Demographics
NPI:1245865062
Name:TEXAS FOOT AND ANKLE CONSULTANTS LLC
Entity type:Organization
Organization Name:TEXAS FOOT AND ANKLE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:NAVID
Authorized Official - Last Name:DELPAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:321-373-3442
Mailing Address - Street 1:628 NORTHILL DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5112
Mailing Address - Country:US
Mailing Address - Phone:321-373-3442
Mailing Address - Fax:
Practice Address - Street 1:399 W CAMPBELL RD STE 103
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3615
Practice Address - Country:US
Practice Address - Phone:321-373-3442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty