Organization
KIRUSAM LLC
Active
Other names
Broadway G foot ankle and wound care
Organization subpart
No
Provider details
NPI number
Authorized official
KIRUBEL T GEBRESENBET (MANAGER)
(972) 435-6096
Entity
Organization
Contact information
Practice address
2910 BROADWAY BLVD STE 212, GARLAND, TX 75041-3794
(972) 435-6096
(972) 521-6953
Mailing address
2080 GLENCOE DR, ROCKWALL, TX 75087-2400
(972) 435-6096
(972) 521-6953
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
10/18/2025
Last updated
04/02/2026
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