Provider Demographics
NPI:1366091704
Name:CARROLLTON PODIATRIST PLLC
Entity type:Organization
Organization Name:CARROLLTON PODIATRIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-492-4660
Mailing Address - Street 1:3730 N JOSEY LN STE 120
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2439
Mailing Address - Country:US
Mailing Address - Phone:972-492-4660
Mailing Address - Fax:972-492-0488
Practice Address - Street 1:3730 N JOSEY LN STE 120
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2439
Practice Address - Country:US
Practice Address - Phone:972-492-4660
Practice Address - Fax:972-492-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty