| NPI | 1124610142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MARCIANO President 817-424-3668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery |
| 213ER0200X Podiatrist Radiology | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 213ES0131X Podiatrist Foot Surgery | |
| 261QP1100X Clinic/Center Podiatric | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |