Provider Demographics
NPI:1396229837
Name:RICHMOND PREMIER FOOT & ANKLE CLINIC PLLC
Entity Type:Organization
Organization Name:RICHMOND PREMIER FOOT & ANKLE CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYI
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:OTERI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:832-798-5283
Mailing Address - Street 1:7303 WOODED LAKE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7832
Mailing Address - Country:US
Mailing Address - Phone:832-798-5283
Mailing Address - Fax:
Practice Address - Street 1:1000 AUSTIN ST STE UNITD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5275
Practice Address - Country:US
Practice Address - Phone:713-384-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty