Individual
DR. ALAN ETTINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM PA
Contact information
Practice address
1001 12TH ST STE 104, FORT WORTH, TX 76104-3928
(817) 738-1931
(817) 738-6990
Mailing address
1001 12TH ST STE 104, FORT WORTH, TX 76104-3928
(817) 738-1931
(817) 738-6990
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092827702
—
TX
01
—
4097506
AETNA
TX
Enumeration date
06/28/2006
Last updated
10/15/2009
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