Anderson Podiatry PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1534 Issued in TX

Legal business name

ANDERSON PODIATRY PLLC

Practice address

1407 S Fleishel Ave Ste 301
Tyler, TX 75701-3388

Phone

(903) 593-6104

Fax

(903) 597-8931

NPI assigned

Jan 6, 2012

Last updated

Feb 7, 2012By 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. Evangela Lashun Anderson, DPMNPI 1285644302

Title

Owner

Phone

(903) 593-6104

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evangela L Anderson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tyler, TX
  • NPI 1285644302
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1992075063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 S FLEISHEL AVE STE 301",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013388",
            "telephone_number": "903-593-6104",
            "fax_number": "903-597-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 S FLEISHEL AVE STE 301",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013388",
            "telephone_number": "903-593-6104",
            "fax_number": "903-597-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "EVANGELA",
        "authorized_official_middle_name": "LASHUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-593-6104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146745801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Amrhein
• Amy Furqueron, LLC
• Nkechi Alexandra Anako
• Edwin Alexander Anders, MD
• Latonia Anders
• Alan Anderson
• Alonna R Anderson
• Anthony Anderson, P.A.
• Candice Anderson
• Courtney Anderson

• Foot & Ankle Surgery Podiatrist in Tyler, TX
• Providers in Tyler, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.