Ettinger, Alan
Ettinger, Alan is an sole proprietor health care provider with primary practice located at 1001 12Th St Ste 104 , Fort Worth TX 76104-3928. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Ettinger, Alan can be contacted via phone (817) 738-1931.Contact Information
Primary practice address
1001 12Th St Ste 104
Fort Worth TX 76104-3928
Phone: (817) 738-1931
Fax: (817) 738-6990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 0469 | Texas |
Profile Details
| NPI number | 1295762771 |
|---|---|
| LBN Legal business name | Ettinger, Alan |
| Credentials | DPM PA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Oct 15th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295762771 | NPPES |
| Texas | MEDICAID | 092827702 | |
| Texas | Other | 4097506 |
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