Provider Demographics
NPI:1558780999
Name:AMIN, KUNAL (DPM)
Entity Type:Individual
Prefix:
First Name:KUNAL
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 TIKI DR STE D
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1678
Mailing Address - Country:US
Mailing Address - Phone:281-391-1212
Mailing Address - Fax:
Practice Address - Street 1:7609 TIKI DR STE D
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1678
Practice Address - Country:US
Practice Address - Phone:281-391-1212
Practice Address - Fax:973-762-9262
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2369213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty