Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jeremy William Brouillette, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1477969806

Mr. Jeremy William Brouillette, DPM is a Podiatry in Southlake, Texas. Qualified in 2014, 12 years ago. Practices with Foot and Ankle Specialists of the Mid-Atlantic LLC, a 154-clinician group and accepts Medicare assignment. Licensed in Texas, Virginia and West Virginia.

Years since qualifying
12
Licensed in
TX, VA, WV
In the registry since
2014
Specialties on file
3
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Partly verified

Some contact details are missing from the federal record.

Academy Foot & Ankle Specialists 1940 E State Hwy 114 Ste 150
Southlake, TX 76092-6526
Phone: (817) 424-3668
Fax: (817) 442-8637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 692085 (TX)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 10448 (WV)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 0103301199 (VA)

Record details

NPI number1477969806
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedJuly 7, 2014
Last updated in NPPESMarch 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Foot And Ankle Specialists Of The Mid-Atlantic Llc — 154 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Southlake