# DR. ALAN ETTINGER DPM PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598943219
- **Authorized official:** DR. ALAN ETTINGER DPM PA (DOCTOR)
- **Authorized official phone:** (817) 738-1931

## Contact information

- **Practice address:** 1001 12TH AVE STE 104, FORT WORTH, TX 76104-3928
- **Practice address phone:** (817) 738-1931
- **Practice address fax:** (817) 738-6990
- **Mailing address:** 1001 12TH AVE STE 104, FORT WORTH, TX 76104-3928
- **Mailing address phone:** (817) 738-1931
- **Mailing address fax:** (817) 738-6990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0469 | TX | Yes |

## Other

- **Enumeration date:** 02/05/2008
- **Last updated:** 02/15/2008