Provider Demographics
NPI:1417205568
Name:ACHILLES FOOT AND ANKLE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:ACHILLES FOOT AND ANKLE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUITRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-586-6705
Mailing Address - Street 1:4131 DIRECTORS ROW
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-8703
Mailing Address - Country:US
Mailing Address - Phone:713-586-6778
Mailing Address - Fax:
Practice Address - Street 1:4120 DIRECTORS ROW
Practice Address - Street 2:STE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8740
Practice Address - Country:US
Practice Address - Phone:713-586-6778
Practice Address - Fax:713-586-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID