Provider Demographics
NPI:1982115259
Name:FIRST STEP FOOT AND ANKLE CENTER
Entity Type:Organization
Organization Name:FIRST STEP FOOT AND ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-910-7172
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-0050
Mailing Address - Country:US
Mailing Address - Phone:281-910-7172
Mailing Address - Fax:281-503-7812
Practice Address - Street 1:15003 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-4375
Practice Address - Country:US
Practice Address - Phone:281-910-7172
Practice Address - Fax:281-503-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2189213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty