Provider Demographics
NPI:1265630024
Name:PALERMO & WEBB DPM PTNRS
Entity Type:Organization
Organization Name:PALERMO & WEBB DPM PTNRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PALERMO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-455-1204
Mailing Address - Street 1:12726 WOODFOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015
Mailing Address - Country:US
Mailing Address - Phone:713-455-1204
Mailing Address - Fax:713-455-1205
Practice Address - Street 1:12726 WOODFOREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2774
Practice Address - Country:US
Practice Address - Phone:713-455-1204
Practice Address - Fax:713-455-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP653 PALERMO213E00000X
TX1297 WEBB213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCI 4284OtherRR MEDICARE
TX120443002Medicaid
TX018824501Medicaid
TX5143220001Medicare NSC
TX80Y431Medicare ID - Type Unspecified
TXCI 4284OtherRR MEDICARE
U55680Medicare UPIN
TX00FF65Medicare ID - Type Unspecified
TX018824501Medicaid
TX120443002Medicaid