MEDICARE: PREFERRED FOOT SPECIALISTS OF TEXAS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	1557	TX

General Provider Information

NPI Number	:	1164677753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED FOOT SPECIALISTS OF TEXAS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 130937
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77219-0937
Country	:	US
Telephone Number	:	713-533-0840
Fax Number	:	713-533-0871

Provider Business Practice Location Address
First Line	:	114 W DREW ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-2002
Country	:	US
Telephone Number	:	713-533-0840
Fax Number	:	713-533-0871

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JOSE J BARRETO
Credential	:	DPM
Telephone Number	:	713-533-0840

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	08/03/2012

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