South Side Med Ex

LBN: South Side Foot Clinic Inc.
South Side Med Ex is an health care organization with primary practice located at 4759 South Fwy Suite B, Fort Worth TX 76115-3655. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. South Side Foot Clinic Inc. can be contacted via phone (817) 923-1953, or through Khanna, Vickie via phone (817) 923-1953.

Contact Information

Primary practice address
4759 South Fwy Suite B Fort Worth TX 76115-3655
Phone: (817) 923-1953
Fax: (817) 923-9615
Website:
Map and Directions
Authorized official contact:
Name: Khanna, Vickie
Phone: (817) 923-1953

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X

Profile Details

NPI number 1205980232
LBN Legal business name South Side Foot Clinic Inc.
DBA Doing business as South Side Med Ex
Authorized official Khanna, Vickie
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 2007
Last updated Oct 10th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205980232 NPPES
Texas MEDICAID 186646901

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