Provider Demographics
NPI:1528263712
Name:NORTH TEXAS FOOT & ANKLE, P.A.
Entity type:Organization
Organization Name:NORTH TEXAS FOOT & ANKLE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HAUSENFLUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:214-369-3969
Mailing Address - Street 1:9401 LBJ FWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4546
Mailing Address - Country:US
Mailing Address - Phone:214-369-3969
Mailing Address - Fax:214-369-6259
Practice Address - Street 1:9401 LBJ FWY
Practice Address - Street 2:SUITE 320
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4546
Practice Address - Country:US
Practice Address - Phone:214-369-3969
Practice Address - Fax:214-369-6259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1516213ES0131X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168695801Medicaid
TXU81593Medicare UPIN
5025080001Medicare NSC
TX168695801Medicaid