Healthcare Provider Details

I. General information

NPI: 1730971045
Provider Name (Legal Business Name): BRAZOS FOOT & ANKLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 WASHINGTON AVE
WACO TX
76710-7447
US

IV. Provider business mailing address

2524 WASHINGTON AVE
WACO TX
76710-7447
US

V. Phone/Fax

Practice location:
  • Phone: 254-300-7703
  • Fax: 254-300-7709
Mailing address:
  • Phone: 254-300-7703
  • Fax: 254-300-7709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH SAPPINGTON
Title or Position: SOLE MEMBER
Credential: DPM
Phone: 254-300-7703