Provider Demographics
NPI:1881695278
Name:HANDZEL, CHARLEEN MARIE (DPM)
Entity type:Individual
Prefix:
First Name:CHARLEEN
Middle Name:MARIE
Last Name:HANDZEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 PAISLEY DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7209
Mailing Address - Country:US
Mailing Address - Phone:972-814-2427
Mailing Address - Fax:972-691-7921
Practice Address - Street 1:1422 MAIN ST
Practice Address - Street 2:SUITE 249
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7625
Practice Address - Country:US
Practice Address - Phone:817-329-0013
Practice Address - Fax:817-410-1412
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2013-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1434213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8453N0Medicare PIN