Healthcare Provider Details

I. General information

NPI: 1205282423
Provider Name (Legal Business Name): ELNAZ SABETI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 11/27/2023
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 RICHMOND AVE STE 250
HOUSTON TX
77042-4643
US

IV. Provider business mailing address

14770 MEMORIAL DR STE 150
HOUSTON TX
77079-5238
US

V. Phone/Fax

Practice location:
  • Phone: 713-523-6700
  • Fax: 713-523-2626
Mailing address:
  • Phone: 281-501-3443
  • Fax: 713-523-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2391
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: