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General NPI Number Information
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NPI Number | 1558741934
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Entity Type | Organization
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Legal Business Name | HAPPY FEET CUSTOM SHOES AND MEDICAL SUPPLIES
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 7909 S SAM HOUSTON PKWY E 1112
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City | HOUSTON
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State | TX
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Zip | 77075-4780
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Country | US
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Telephone | 281-901-8895
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Fax |
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Provider Business Mailing Address
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Address Line | 7909 S SAM HOUSTON PKWY E 1112
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City | HOUSTON
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State | TX
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Zip | 77075-4780
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Country | US
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Telephone | 281-901-8895
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CORNELIUS B. YANCY SR.
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Credential |
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Telephone | 281-901-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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