Provider Demographics
NPI:1396186904
Name:MBV PLLC
Entity Type:Organization
Organization Name:MBV PLLC
Other - Org Name:FOOT & ANKLE SPECIALISTS OF THE WOODLANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIN
Authorized Official - Middle Name:NOBLE
Authorized Official - Last Name:VACLAW
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-909-7722
Mailing Address - Street 1:9191 PINECROFT DR.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2799
Mailing Address - Country:US
Mailing Address - Phone:281-909-7722
Mailing Address - Fax:281-909-7733
Practice Address - Street 1:9191 PINECROFT DR.
Practice Address - Street 2:SUITE 225
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2799
Practice Address - Country:US
Practice Address - Phone:281-909-7722
Practice Address - Fax:281-909-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2052213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty