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General NPI Number Information
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NPI Number | 1407415227
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Entity Type | Organization
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Legal Business Name | VITAL PODIATRY PLLC
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 13636 BRETON RIDGE ST STE D
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City | HOUSTON
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State | TX
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Zip | 77070-6077
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Country | US
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Telephone | 281-937-4546
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Fax | 346-998-1661
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Provider Business Mailing Address
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Address Line | 13636 BRETON RIDGE ST STE D
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City | HOUSTON
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State | TX
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Zip | 77070-6077
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Country | US
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Telephone | 281-937-4546
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Fax | 346-998-1661
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Authorized Official
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Title or Position | PRESIDENT
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Name | RIZWAN TAI
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Credential | DPM
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Telephone | 713-458-0419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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