Provider Demographics
NPI:1497808133
Name:LOUETTA FOOT AND ANKLE SPECIALISTS, P. A.
Entity Type:Organization
Organization Name:LOUETTA FOOT AND ANKLE SPECIALISTS, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BACHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-370-0648
Mailing Address - Street 1:16835 DEER CREEK DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4968
Mailing Address - Country:US
Mailing Address - Phone:281-370-0648
Mailing Address - Fax:281-251-3350
Practice Address - Street 1:16835 DEER CREEK DR
Practice Address - Street 2:SUITE 150
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4968
Practice Address - Country:US
Practice Address - Phone:281-370-0648
Practice Address - Fax:281-251-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT12012Medicare UPIN