Provider Demographics
NPI:1124610142
Name:ACADEMY FOOT & ANKLE SPECIALISTS AT ARGYLE
Entity type:Organization
Organization Name:ACADEMY FOOT & ANKLE SPECIALISTS AT ARGYLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:817-424-3668
Mailing Address - Street 1:1940 E STATE HIGHWAY 114 STE 150
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6526
Mailing Address - Country:US
Mailing Address - Phone:817-424-3668
Mailing Address - Fax:
Practice Address - Street 1:7226 CRAWFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2675
Practice Address - Country:US
Practice Address - Phone:817-424-3668
Practice Address - Fax:817-442-8637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HM PODIATRY PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiologyGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty