| Organization Name: | ADVANCED FOOT SPECIALISTS, PLLC |
| NPI Number: | 1104233675 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BENJAMIN A BASSICHIS (OWNER) |
| Mailing Address: | 201 E Interstate 30 Suite B Rockwall |
| State: | TX US |
| Postal Code: | 750875402 |
| Phone Number: | 2147713668 |
| Fax Number: | 9727740066 |
| NPI Enumeration Date: | 07/16/2014 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 2086 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |