Organization
SOUTHWEST AUSTIN FOOT & ANKLE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DEE WHITESIDES (OWNER)
(512) 789-1190
Entity
Organization
Contact information
Practice address
5625 EIGER RD STE 110, AUSTIN, TX 78735-8978
(512) 447-4122
(512) 727-0505
Mailing address
5625 EIGER RD STE 110, AUSTIN, TX 78735-8978
(512) 447-4122
(512) 727-0505
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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