Fort Worth Foot Clinic

Primary specialty

PodiatristTaxonomy code 213E00000X

License

TX1254 Issued in TX

Legal business name

FORT WORTH FOOT CLINIC

Practice address

4759 B South Freeway
Fort Worth, TX 76115

Phone

(817) 923-1953

Fax

(817) 923-9615

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vickie Vijay Khanna, DPM

Title

Director

Phone

(817) 923-1953

Specialties & licenses 1

Addresses

Tax ID family

Fort Worth Foot Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Worth Foot Clinic

  dba Fort Worth Med Ex

  • Durable Medical Equipment & Medical Supplies
  • Fort Worth, TX
  • NPI 1043394497
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871677203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4759 B SOUTH FREEWAY",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "76115",
            "telephone_number": "817-923-1953",
            "fax_number": "817-923-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4759 B SOUTH FREEWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76115",
            "telephone_number": "817-923-1953",
            "fax_number": "817-923-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "VICKIE VIJAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-923-1953",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "TX1254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Worth Family Chiropractic
• Fort Worth Family Practice Associated
• Fort Worth Fertility
• Fort Worth Foot and Ankle, PLLC
• Fort Worth Foot Clinic (Fort Worth Med Ex)
• Fort Worth Hand Center
• Fort Worth Head Neck and Jaw PLLC (Ried Physical Therapy)
• Fort Worth Health Alliance, LLC
• Fort Worth Health Rejuvenation
• Fort Worth Health, LLC

• Podiatrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.