1578921672 NPI number — ADVANCED FOOT SPECIALISTS, PLLC

Table of content: SARAH KATHERINE NICKOLAS OT (NPI 1487359386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578921672 NPI number — ADVANCED FOOT SPECIALISTS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED FOOT SPECIALISTS, PLLC
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:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1578921672
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4004 MEDICAL PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75401-7854
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-771-3668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4004 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75401-7854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-771-3668
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HUSSAIN
Authorized Official First Name:
KAMRAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DR. KAMRAN HUSSAIN, DPM
Authorized Official Telephone Number:
214-771-3668

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  2086 , 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)





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