Provider Demographics
NPI:1871544858
Name:CUTLER, FRED H (DPM)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:H
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CASA LINDA PLAZA
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3415
Mailing Address - Country:US
Mailing Address - Phone:214-328-3501
Mailing Address - Fax:214-328-3502
Practice Address - Street 1:400 CASA LINDA PLZ
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3481
Practice Address - Country:US
Practice Address - Phone:214-328-3501
Practice Address - Fax:214-328-3502
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0596213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T12877Medicare UPIN
00HJ64Medicare ID - Type Unspecified
TX4223430001Medicare NSC