Provider Demographics
NPI:1922180769
Name:ARIEL'S VILLAGE SHOE SHOP
Entity Type:Organization
Organization Name:ARIEL'S VILLAGE SHOE SHOP
Other - Org Name:VILLAGE SHOE SHOP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:EMILY
Authorized Official - Last Name:ALMOGABAR
Authorized Official - Suffix:
Authorized Official - Credentials:CPED RN, BSN
Authorized Official - Phone:713-528-8424
Mailing Address - Street 1:2507 RICE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3220
Mailing Address - Country:US
Mailing Address - Phone:713-528-8424
Mailing Address - Fax:713-528-2221
Practice Address - Street 1:2507 RICE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-3220
Practice Address - Country:US
Practice Address - Phone:713-528-8424
Practice Address - Fax:713-528-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9479332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0583150001Medicare NSC