Doctor Name: | DORA EDA ACHILLE |
NPI Number: | 1013952514 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | 1456 |
Business Practice Address: | 3208 Long Prairie Rd Suite B Flower Mound, TX - 750222718 |
Business Phone Number: | 9725398488 |
Business Fax Number: | 9728741107 |
Mailing Address: | 3208 Long Prairie Rd, Suite B FLOWER MOUND |
State: | TX |
Postal Code: | 750222718 |
Phone Number: | 9725398488 |
Fax Number: | 9728741107 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 1456 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |