1588306492 NPI number — JOY FOOT AND ANKLE CLINIC, PLLC

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 1588306492 NPI number — JOY FOOT AND ANKLE CLINIC, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOY FOOT AND ANKLE CLINIC, 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:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588306492
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
675 TOWN SQUARE BLVD BLDG 1A
Provider Second Line Business Mailing Address:
SUITE 200. PMB 418
Provider Business Mailing Address City Name:
GARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75040-2991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-443-4070
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
675 TOWN SQUARE BLVD BLDG 1A
Provider Second Line Business Practice Location Address:
SUITE 200. PMB 418
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75040-2991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-443-4070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2022

Additional Information

Authorized Official

Authorized Official Last Name:
KHO
Authorized Official First Name:
HYUN YOUNG
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
201-956-8899

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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