Provider Demographics
NPI:1083948566
Name:HOUSTON FOOT DOCTOR, PC
Entity Type:Organization
Organization Name:HOUSTON FOOT DOCTOR, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-7208
Mailing Address - Street 1:9405 HUFFMEISTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2891
Mailing Address - Country:US
Mailing Address - Phone:281-463-7208
Mailing Address - Fax:281-463-1035
Practice Address - Street 1:9405 HUFFMEISTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2891
Practice Address - Country:US
Practice Address - Phone:281-463-7208
Practice Address - Fax:281-463-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0644213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1083948566OtherNPI
TX00EN74OtherMEDICARE ID
TX1083948566OtherNPI
TXT14518Medicare UPIN
TX0313020001Medicare NSC