Healthcare Provider Details

I. General information

NPI: 1962086439
Provider Name (Legal Business Name): EPIC FOOT & ANKLE CENTERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7619 BRANFORD PL STE 250
SUGAR LAND TX
77479-3760
US

IV. Provider business mailing address

5618 KING PLAINS CREEK LN
SUGAR LAND TX
77479-7042
US

V. Phone/Fax

Practice location:
  • Phone: 281-515-8120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: SHAFIQ PRASLA
Title or Position: MANAGING MEMBER
Credential: DPM
Phone: 832-755-7670