Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | LPO 53 | TX |
N | 222Z00000X | Podiatrist | LPO 53 | TX |
Y | 224P00000X | Prosthetist | LPO 53 | TX |
NPI | 1346487311 |
---|---|
Provider Name | Mark W Ashford |
First Address | Fort Worth, TX 76104-4250 |
Second Address | Fort Worth, TX 76104-4250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 13/01/2009 |