1225207848 NPI number — FRANCHISEE OF FOOT SOLUTIONS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225207848 NPI number — FRANCHISEE OF FOOT SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCHISEE OF FOOT SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FOOT SOLUTIONS PLANO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225207848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 EAGLE RIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORINTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76210-3040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-473-7249
Provider Business Mailing Address Fax Number:
972-473-7630

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 DALLAS PKWY
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-4363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-473-7249
Provider Business Practice Location Address Fax Number:
972-473-7630
Provider Enumeration Date:
02/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CARO
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
940-321-5928

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X , with the licence number:  0079577 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0079577 . This is a "STATE LICSNSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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