Healthcare Provider Details

I. General information

NPI: 1770424749
Provider Name (Legal Business Name): EAGLE-SUMMIT FOOT & ANKLE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 SUMMIT BLVD UNIT 15
FRISCO CO
80443-5882
US

IV. Provider business mailing address

PO BOX 844342
LOS ANGELES CA
90084-4342
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-4565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN THOMAS MAURER
Title or Position: OWNER
Credential:
Phone: 970-949-0500