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General NPI Number Information
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NPI Number | 1568563559
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Entity Type | Organization
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Legal Business Name | ADVANCED DIAGNOSTIC FOOT & ANKLE SPECIALISTS OF GREATER HOUSTON PLLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 21720 KINGSLAND BLVD SUITE 303B
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City | KATY
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State | TX
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Zip | 77450-2550
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Country | US
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Telephone | 281-579-5670
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Fax | 281-579-5671
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Provider Business Mailing Address
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Address Line | 21720 KINGSLAND BLVD SUITE 303B
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City | KATY
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State | TX
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Zip | 77450-2550
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Country | US
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Telephone | 281-579-5670
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Fax | 281-579-5671
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBRA IRELAND
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Credential | P.M.A.C.
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Telephone | 281-579-5670
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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 | TX
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