=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487464673
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WASHBURN FOOT AND ANKLE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2025
-----------------------------------------------------
Last Update Date | 01/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2201 W HOLCOMBE BLVD STE 230
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-442-5207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6711 38TH AVE N
-----------------------------------------------------
City | SAINT PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33710-1536
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-442-5207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICIAN
-----------------------------------------------------
Name | DR. JAMES WASHBURN
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 501-442-5207
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------