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General NPI Number Information
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NPI Number | 1528061793
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Entity Type | Organization
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Legal Business Name | HEART OF TEXAS FOOT CARE CENTER, P.A.
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 103 A SOUTH PARK DR.
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City | BROWNWOOD
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State | TX
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Zip | 76801
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Country | US
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Telephone | 326-646-0715
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Fax | 325-646-3734
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Provider Business Mailing Address
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Address Line | 103 A SOUTH PARK DR.
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City | BROWNWOOD
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State | TX
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Zip | 76801
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Country | US
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Telephone | 326-646-0715
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Fax | 325-646-3734
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | BOHN MARSHALL YOUNG
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Credential | D.P.M.
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Telephone | 325-646-0715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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