Healthcare Provider Details

I. General information

NPI: 1396229837
Provider Name (Legal Business Name): RICHMOND PREMIER FOOT & ANKLE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MAIN ST STE 204
RICHMOND TX
77469-3230
US

IV. Provider business mailing address

1601 MAIN ST STE 204
RICHMOND TX
77469-3230
US

V. Phone/Fax

Practice location:
  • Phone: 832-449-3520
  • Fax: 855-398-4568
Mailing address:
  • Phone: 832-449-3520
  • Fax: 855-398-4568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SEYI JENNIFER OTERI
Title or Position: PHYSICIAN
Credential: DPM
Phone: 832-449-3520