Organization
FORT WORTH FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKIE VIJAY KHANNA DPM (DIRECTOR)
(817) 923-1953
Entity
Organization
Contact information
Practice address
4759 B SOUTH FREEWAY, FORT WORTH, TX 76115
(817) 923-1953
(817) 923-9615
Mailing address
4759 B SOUTH FREEWAY, FT WORTH, TX 76115
(817) 923-1953
(817) 923-9615
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TX1254
TX
Other
Enumeration date
10/24/2006
Last updated
08/22/2020
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