Provider Demographics
NPI:1003646803
Name:OPTIMUM FOOT CARE, L.L.C.
Entity type:Organization
Organization Name:OPTIMUM FOOT CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:YACARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-463-3668
Mailing Address - Street 1:103 SMART PL # 2
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2070
Mailing Address - Country:US
Mailing Address - Phone:985-463-3668
Mailing Address - Fax:985-463-3600
Practice Address - Street 1:103 SMART PL # 2
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2070
Practice Address - Country:US
Practice Address - Phone:985-462-3668
Practice Address - Fax:985-463-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty