Dr. Alan Ettinger
Primary Podiatric Medicine
1001 12th St Ste 104
Fort Worth
, Texas 76104-3928
Dr. Alan Ettinger
Primary Podiatric Medicine
1001 12th St Ste 104
Fort Worth
, Texas 76104-3928
(817) 738-6990
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About
Features
Specialties
- Primary Podiatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Alan Ettinger
- 1001 12th St Ste 104
- Fort Worth, TX
- Zip : 76104-3928
- Fax : (817) 738-6990
- Phone : (817) 738-1931
Second Address
- Dr. Alan Ettinger
- 1001 12th St Ste 104
- Fort Worth, TX
- Zip : 76104-3928
- Fax : (817) 738-6990
- Phone : (817) 738-1931
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | 0469 | TX |
National Provider Identifier
| NPI | 1295762771 |
|---|---|
| Provider Name | Dr. Alan Ettinger |
| First Address | Fort Worth, TX 76104-3928 |
| Second Address | Fort Worth, TX 76104-3928 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2006 |
| Last Update Date | 15/10/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 092827702 | (05) | TX |
| 4097506 | AETNA (01) | TX |
| T13199 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.