Provider Demographics
NPI:1497578561
Name:COMMUNITY HEALTH PODIATRY
Entity type:Organization
Organization Name:COMMUNITY HEALTH PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-544-2720
Mailing Address - Street 1:4006 BELT LINE RD STE 185
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4371
Mailing Address - Country:US
Mailing Address - Phone:346-544-2720
Mailing Address - Fax:
Practice Address - Street 1:4006 BELT LINE RD STE 185
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4371
Practice Address - Country:US
Practice Address - Phone:346-544-2720
Practice Address - Fax:888-548-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty