Provider Demographics
NPI:1346949906
Name:CENTERS FOR ADVANCED FOOT CARE
Entity Type:Organization
Organization Name:CENTERS FOR ADVANCED FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-531-4100
Mailing Address - Street 1:12121 RICHMOND AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2439
Mailing Address - Country:US
Mailing Address - Phone:281-531-4100
Mailing Address - Fax:281-531-9600
Practice Address - Street 1:830 S MASON RD STE B5
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3863
Practice Address - Country:US
Practice Address - Phone:281-392-0149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty