Provider Demographics
NPI:1356555692
Name:ANKLE AND FOOT SPECIALISTS, PA
Entity type:Organization
Organization Name:ANKLE AND FOOT SPECIALISTS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:936-756-0800
Mailing Address - Street 1:2010 S LOOP 336 W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3312
Mailing Address - Country:US
Mailing Address - Phone:936-756-0800
Mailing Address - Fax:
Practice Address - Street 1:2010 S LOOP 336 W
Practice Address - Street 2:SUITE 100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304
Practice Address - Country:US
Practice Address - Phone:936-756-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0854213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00907YMedicare PIN
TX5428650001Medicare NSC
TXT15478Medicare UPIN