MEDICARE: LUPS LLC DBA FOOT SOLUTIONS

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	332B00000X	Durable Medical Equipment & Medical Supplies	CPED2483	TX

General Provider Information

NPI Number	:	1255548053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUPS LLC DBA FOOT SOLUTIONS

Provider Business Mailing Address
First Line	:	5318 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1349
Country	:	US
Telephone Number	:	713-522-4335
Fax Number	:	713-529-5256

Provider Business Practice Location Address
First Line	:	5318 KIRBY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1349
Country	:	US
Telephone Number	:	713-522-4335
Fax Number	:	713-529-5256

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DARRELL CLOUGH
Credential	:
Telephone Number	:	713-522-4335

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	05/20/2011

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