Provider Demographics
NPI:1154932812
Name:DELARA FOOT AND ANKLE PLLC
Entity type:Organization
Organization Name:DELARA FOOT AND ANKLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:DELARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:817-928-3231
Mailing Address - Street 1:1604 HOSPITAL PKWY STE 309
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6931
Mailing Address - Country:US
Mailing Address - Phone:817-928-3231
Mailing Address - Fax:
Practice Address - Street 1:1604 HOSPITAL PKWY STE 309
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6931
Practice Address - Country:US
Practice Address - Phone:817-928-3231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty