Healthcare Provider Details

I. General information

NPI: 1780700013
Provider Name (Legal Business Name): LOUETTA FOOT AND ANKLE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8681 LOUETTA RD SUITE 150
SPRING TX
77379-6681
US

IV. Provider business mailing address

8681 LOUETTA ROAD SUITE 150
SPRING TX
77379
US

V. Phone/Fax

Practice location:
  • Phone: 281-370-0648
  • Fax: 281-251-3350
Mailing address:
  • Phone: 281-370-0648
  • Fax: 281-251-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1010
License Number StateTX

VIII. Authorized Official

Name: DR. BRAD JEFFREY BACHMANN
Title or Position: OWNER
Credential: D.P.M.
Phone: 281-370-0648