Provider Demographics
NPI:1649312471
Name:THERAPEUTIC FOOTWEAR INC.
Entity type:Organization
Organization Name:THERAPEUTIC FOOTWEAR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-220-1225
Mailing Address - Street 1:309 EL PASO ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-5005
Mailing Address - Country:US
Mailing Address - Phone:210-220-1225
Mailing Address - Fax:210-220-1227
Practice Address - Street 1:309 EL PASO ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-5005
Practice Address - Country:US
Practice Address - Phone:210-220-1225
Practice Address - Fax:210-220-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000532132OtherBCBS TX
TX0007882033OtherAETNA
TX0000532132OtherBCBS TX
TX=========OtherNALC HBP
TX0007882033OtherAETNA
TX=========-000OtherAFLAC
TX=========-000OtherAFLAC