NPIMap

Organization Active NPI

Fas of TW LLC

  • Foot & Ankle Surgery Podiatrist
  • Shenandoah, TX
National Provider Identifier
1942011986
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FAS OF TW LLC
Practice address
9191 Pinecroft Dr Ste 100
Shenandoah, TX 77380-2797
Phone
(346) 590-2730
NPI assigned
Jan 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Marcin Noble Vaclaw, DPMNPI 1245544691
Title
Physician
Phone
(281) 909-7722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

9191 Pinecroft Dr Ste 100
Shenandoah, TX 77380-2797

Mailing address

434 W Ascension Way Ste 425
Murray, UT 84123-3102
Phone (801) 292-4425

National Provider Directory

National Provider Directory

Locations

7575 San Felipe St
Ste 301
Houston, TX 77063
Phone (346) 597-7161

227 State Highway 75 N
Ste 150
Huntsville, TX 77320

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1942011986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 W ASCENSION WAY STE 425",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841233102",
            "telephone_number": "801-292-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 PINECROFT DR STE 100",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773802797",
            "telephone_number": "346-590-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAS OF TW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "VACLAW",
        "authorized_official_first_name": "MARCIN",
        "authorized_official_middle_name": "NOBLE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "281-909-7722",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.