Greater Texas Foot & Ankle Specialist Limited Liability Company

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

GREATER TEXAS FOOT & ANKLE SPECIALIST LIMITED LIABILITY COMPANY

Practice address

12500 Lebanon Rd Ste 104
Frisco, TX 75035-9474

Phone

(469) 384-2135

Fax

(469) 252-1064

NPI assigned

May 5, 2021

Organization subpart

No

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

Authorized official

Name

Dean Donghyun Kim, DPMNPI 1659891836

Title

Physician

Phone

(469) 384-2135

Specialties & licenses 1

Addresses

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.

• Dean Donghyun Kim, DPM

  • Podiatrist
  • Frisco, TX
  • NPI 1659891836
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1992389068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 LEBANON RD STE 104",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750359474",
            "telephone_number": "469-384-2135",
            "fax_number": "469-252-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 LEBANON RD STE 104",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750359474",
            "telephone_number": "469-384-2135",
            "fax_number": "469-252-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER TEXAS FOOT & ANKLE SPECIALIST LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-05",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "DONGHYUN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "469-384-2135",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Chevelle Gray
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• Angela Graybill, M. ED. CCC/SLP
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• Katrice Green-Thompkins
• Aaron Green
• Hannah Green

• Podiatrist in Frisco, TX
• Providers in Frisco, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.