Healthcare Provider Details

I. General information

NPI: 1962517680
Provider Name (Legal Business Name): CENTERS FOR ADVANCED FOOT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 RICHMOND AVE SUITE 415
HOUSTON TX
77082-2432
US

IV. Provider business mailing address

12000 RICHMOND AVE STE 370
HOUSTON TX
77082-2964
US

V. Phone/Fax

Practice location:
  • Phone: 281-531-4100
  • Fax: 281-531-9600
Mailing address:
  • Phone: 281-531-4100
  • Fax: 281-531-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0850
License Number StateTX

VIII. Authorized Official

Name: DR. ASIA E LO
Title or Position: PRESIDENT
Credential: DPM
Phone: 281-531-4100