MEDICARE: DR. AVA KRISTINE WASHKO DPM

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	213E00000X	Podiatrist	2138	TX
2	213ES0103X	Foot & Ankle Surgery Podiatrist	2138	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	697544	OTHER	TX	MEDICARE PTAN
2	697547	OTHER	TX	MEDICARE PTAN
3	767975	OTHER	TX	MEDICARE PTAN
4	742575	OTHER	TX	MEDICARE PTAN
5	466683	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1669727020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVA KRISTINE WASHKO DPM

Provider Business Mailing Address
First Line	:	119 MEDICAL PARK LN STE D
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-4980
Country	:	US
Telephone Number	:	936-277-1000
Fax Number	:	936-994-9020

Provider Business Practice Location Address
First Line	:	2502 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77003-1523
Country	:	US
Telephone Number	:	713-224-0555
Fax Number	:	713-224-1918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2012
Last Update Date	:	02/28/2024

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