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Individual

DR. RUSSELL PENDLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6312 AZLE AVE, LAKE WORTH, TX 76135-2442
(817) 238-8400
(817) 238-8401
Mailing address
6312 AZLE AVE, LAKE WORTH, TX 76135-2442
(817) 238-8400
(817) 238-8401

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1916
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
214330702
TX
05
214330704
TX
Enumeration date
08/23/2008
Last updated
11/28/2023
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