Provider Demographics
NPI:1639695406
Name:ADVANTAGE FOOT CARE OF HOUSTON, PLLC
Entity Type:Organization
Organization Name:ADVANTAGE FOOT CARE OF HOUSTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RMA, ADMINISTRATION ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:832-835-1442
Mailing Address - Street 1:PO BOX 8411
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8411
Mailing Address - Country:US
Mailing Address - Phone:832-835-1442
Mailing Address - Fax:832-369-1761
Practice Address - Street 1:8313 SOUTHWEST FWY STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1612
Practice Address - Country:US
Practice Address - Phone:832-835-1442
Practice Address - Fax:832-369-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX-2031213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty