Provider Demographics
NPI:1245979384
Name:TEXAS FOOT AND ANKLE SURGICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:TEXAS FOOT AND ANKLE SURGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-912-0172
Mailing Address - Street 1:932 S ST HWY 123 BYP
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-9756
Mailing Address - Country:US
Mailing Address - Phone:830-491-9211
Mailing Address - Fax:833-471-2992
Practice Address - Street 1:3349 S HIGHWAY 181 STE 6
Practice Address - Street 2:
Practice Address - City:KENEDY
Practice Address - State:TX
Practice Address - Zip Code:78119-5247
Practice Address - Country:US
Practice Address - Phone:830-491-9211
Practice Address - Fax:833-471-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty