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General NPI Number Information
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NPI Number | 1497937759
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Entity Type | Organization
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Legal Business Name | CODWELL FAMILY FOOT CENTER, PA
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 6655 TRAVIS ST STE 840
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City | HOUSTON
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State | TX
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Zip | 77030-1342
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Country | US
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Telephone | 713-526-0600
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Fax | 713-526-7121
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Provider Business Mailing Address
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Address Line | 6655 TRAVIS ST STE 840
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City | HOUSTON
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State | TX
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Zip | 77030-1342
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Country | US
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Telephone | 713-526-0600
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Fax | 713-526-7121
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Authorized Official
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Title or Position | OWNER/PRESIDENT/MEDICAL DIRECTOR
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Name | DR. JOHN ELIHUE CODWELL
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Credential | DPM
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Telephone | 713-526-0600
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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 | 4876770001
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License Number State | TX
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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 | 1279
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License Number State | TX
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