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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