Provider Demographics
NPI:1164675377
Name:DOUGLAS E. WEBB DPM & ASSOCIATES PA
Entity Type:Organization
Organization Name:DOUGLAS E. WEBB DPM & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-316-3338
Mailing Address - Street 1:17448 HIGHWAY 3
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4143
Mailing Address - Country:US
Mailing Address - Phone:281-316-3338
Mailing Address - Fax:281-316-0184
Practice Address - Street 1:17448 HIGHWAY 3
Practice Address - Street 2:SUITE 100
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4143
Practice Address - Country:US
Practice Address - Phone:281-316-3338
Practice Address - Fax:281-316-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1297213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0926854OtherAETNA
TX0088CEOtherBLUE CROSS/BLUE SHIELD
TX0088CEOtherBLUE CROSS/BLUE SHIELD
0926854OtherAETNA
TX1222710001Medicare NSC
000202EMedicare PIN