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PODIATRY ASSOCIATES OF TEXAS, LLC 6860 North Dallas Pkwy, Ste 200, Plano, TX 75024 Tel: 4693057171 Fax: 4692121548Patient Name: Gloria Richards Patient DOB: 02011975 Patient Sex: Female Date of Service:
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To fill out the Podiatry Associates of Texas form, follow these steps:
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Start by entering your personal information, including your full name, address, and contact details.
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Provide your health insurance information, including your insurance company's name, policy number, and group number.
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Indicate your reason for seeking podiatry services by checking the appropriate boxes or writing a brief description.
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Provide a detailed medical history, including any existing conditions, allergies, or previous surgeries.
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Podiatry Associates of Texas is a group of podiatrists providing foot and ankle care in Texas.
Podiatrists who are part of the Podiatry Associates of Texas group are required to file.
The filing process for Podiatry Associates of Texas typically involves providing information about the podiatrists in the group and their practice details.
The purpose of Podiatry Associates of Texas is to offer specialized foot and ankle care services to patients in Texas.
Information such as the names of podiatrists in the group, their contact information, and details of their practice must be reported.
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