Provider Demographics
NPI:1558692863
Name:FOUNDATIONS FOOTWEAR, INC.
Entity Type:Organization
Organization Name:FOUNDATIONS FOOTWEAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRENCH
Authorized Official - Last Name:STONE
Authorized Official - Suffix:IV
Authorized Official - Credentials:C PED
Authorized Official - Phone:512-914-8338
Mailing Address - Street 1:4006 CORTINA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4924
Mailing Address - Country:US
Mailing Address - Phone:512-914-8338
Mailing Address - Fax:512-478-4225
Practice Address - Street 1:422 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1229
Practice Address - Country:US
Practice Address - Phone:512-914-8338
Practice Address - Fax:512-478-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2940335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier