Provider Demographics
NPI:1609911692
Name:FOOT AND ANKLE CENTERS OF TEXAS, PA
Entity Type:Organization
Organization Name:FOOT AND ANKLE CENTERS OF TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:AZIZ
Authorized Official - Last Name:REYHANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-554-0111
Mailing Address - Street 1:PO BOX 57310
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7310
Mailing Address - Country:US
Mailing Address - Phone:281-554-0111
Mailing Address - Fax:281-332-1787
Practice Address - Street 1:1108 GULF FWY S STE 106
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5100
Practice Address - Country:US
Practice Address - Phone:281-554-0111
Practice Address - Fax:281-332-1787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDG6258OtherRRMEDICARE
TX191058001Medicaid
TX0044PMOtherBCBSTX
TXDG6258OtherRRMEDICARE
TX6101820002Medicare NSC