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General NPI Number Information
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NPI Number | 1235286485
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Entity Type | Organization
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Legal Business Name | YOUR TOTAL FOOT CARE SPECIALIST PA
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 23230 RED RIVER DR
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City | KATY
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State | TX
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Zip | 77494-2046
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Country | US
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Telephone | 813-953-3382
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Fax | 281-395-3496
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Provider Business Mailing Address
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Address Line | 23230 RED RIVER DR
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City | KATY
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State | TX
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Zip | 77494-2046
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Country | US
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Telephone | 281-395-3338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES M. JACOBS
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Credential | DPM
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Telephone | 281-395-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1064
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License Number State | TX
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