# KIRUSAM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway G foot ankle and wound care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487521134
- **Authorized official:** KIRUBEL T GEBRESENBET (MANAGER)
- **Authorized official phone:** (972) 435-6096

## Contact information

- **Practice address:** 2910 BROADWAY BLVD STE 212, GARLAND, TX 75041-3794
- **Practice address phone:** (972) 435-6096
- **Practice address fax:** (972) 521-6953
- **Mailing address:** 2080 GLENCOE DR, ROCKWALL, TX 75087-2400
- **Mailing address phone:** (972) 435-6096
- **Mailing address fax:** (972) 521-6953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | — | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2025
- **Last updated:** 04/02/2026