Organization
ADVANCED FOOT & ANKLE CENTER OF TEXARKANA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP JOHN HAHN JR. DPM (DOCTOR)
(903) 791-1222
Entity
Organization
Contact information
Practice address
5606 SUMMERHILL RD, TEXARKANA, TX 75503-1819
(903) 791-1222
(903) 791-8310
Mailing address
2801 RICHMOND RD # 62, TEXARKANA, TX 75503-2123
(903) 791-1222
(903) 791-8310
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1134
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018709801
—
TX
05
—
128263717
—
AR
01
—
DR8730
RAILROAD MEDICARE
TX
Enumeration date
05/04/2007
Last updated
10/22/2014
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