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Organization
NORTH CENTRAL TEXAS PODIATRY, PA
Active
Organization
NORTH CENTRAL TEXAS PODIATRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN BRADFORD CARPENTER DPM (OWNER)
(940) 627-6976
Entity
Organization
Contact information
Practice address
1713 S FM 51, 103, DECATUR, TX 76234-3642
(940) 627-6976
(940) 627-3491
Mailing address
1713 S FM 51, 103, DECATUR, TX 76234-3642
(940) 627-6976
(940) 627-3491
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071TY
BCBS
TX
05
—
285988601
—
TX
Enumeration date
09/15/2010
Last updated
01/18/2012
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