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SOUTH SIDE MED EX
NPI 1205980232
Podiatrist in Fort Worth, TX

Active since January 23, 2007
4759 SOUTH FWY, SUITE B, FORT WORTH, TX 76115(817) 923-1953(817) 923-9615 Get Directions Write a Review

NPPES record last updated: October 10, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About South Side Med Ex NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH SIDE MED EX (NPI 1205980232) is a healthcare organization registered as a podiatrist in Fort Worth, Texas and active in the NPI registry since January 2007. The organization lists Vickie Khanna, Secretary, as its authorized official.

NPPES Registry Identity

NPI1205980232
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameSOUTH SIDE FOOT CLINIC INC.
Location Address4759 SOUTH FWY, SUITE BFort Worth, TX 76115-3655
Mailing Address4759 South Fwy, Suite BFort Worth, TX 76115-3655 · (817) 923-1953 · Fax (817) 923-9615
Phone(817) 923-1953
Fax(817) 923-9615
Organization SubpartNo
Authorized OfficialVickie KhannaSecretary · (817) 923-1953
Enumeration DateJanuary 23, 2007
Last NPPES UpdateOctober 10, 2013
✔ NPI 1205980232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
4759 SOUTH FWY, Fort Worth, TX 76115
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Other Names 1

Doing Business AsSouth Side Med Ex

Other Identifiers 3

Medicare UPINU42260TX
Medicare NSC5851170001TX
Medicaid186646901TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREW NGUYEN DAO FNP-C
Nurse Practitioner (Family)
4759 SOUTH FWY
FORT WORTH, TX 76115
Tarrant County (817) 923-7374
SUDATH GUNADEERA RANNULU M.D.
Pediatrics
4759 SOUTH FWY, STE 101
FT WORTH, TX 76115
Tarrant County (972) 293-6300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Side Foot Clinic Inc.'s NPI number?

The NPI number for South Side Foot Clinic Inc. is 1205980232. It was assigned to this organization in the NPPES registry on January 23, 2007. The provider is doing business as South Side Med Ex.

Where is South Side Foot Clinic Inc. located?

South Side Foot Clinic Inc. is located at 4759 South Fwy Suite B, Fort Worth, TX 76115. The listed phone number is (817) 923-1953.

What is South Side Foot Clinic Inc.'s specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

When was this NPI record last updated?

The NPPES record for South Side Foot Clinic Inc. was last updated on October 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.