Organization
J D FAJARDO DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE D FAJARDO DPM (DOCTOR)
(972) 938-1368
Entity
Organization
Contact information
Practice address
1620 W HIGHWAY 287 BUSINESS, WAXAHACHIE, TX 75165-4706
(972) 938-1368
(972) 937-1354
Mailing address
1620 W HIGHWAY 287 BUSINESS, WAXAHACHIE, TX 75165-4706
(972) 938-1368
(972) 937-1354
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0863
TX
213EP0504X
Public Medicine Podiatrist
0863
TX
213EP1101X
Primary Podiatric Medicine Podiatrist
0863
TX
213ER0200X
Radiology Podiatrist
0863
TX
213ES0000X
Sports Medicine Podiatrist
0863
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
0863
TX
213ES0131X
Foot Surgery Podiatrist
Primary
0863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018835101
—
TX
Enumeration date
05/06/2015
Last updated
05/06/2015
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