Provider Demographics
NPI:1467735480
Name:FOOT SOLUTIONS MEMORIAL
Entity Type:Organization
Organization Name:FOOT SOLUTIONS MEMORIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SEPPALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-759-3668
Mailing Address - Street 1:1560 ELDRIDGE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1762
Mailing Address - Country:US
Mailing Address - Phone:281-759-3668
Mailing Address - Fax:281-493-2064
Practice Address - Street 1:1560 ELDRIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1762
Practice Address - Country:US
Practice Address - Phone:281-759-3668
Practice Address - Fax:281-493-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies