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General NPI Number Information
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NPI Number | 1639695406
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Entity Type | Organization
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Legal Business Name | ADVANTAGE FOOT CARE OF HOUSTON, PLLC
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 8313 SOUTHWEST FWY STE 105
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City | HOUSTON
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State | TX
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Zip | 77074-1612
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Country | US
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Telephone | 832-835-1442
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Fax | 832-369-1761
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Provider Business Mailing Address
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Address Line | PO BOX 8411
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City | HOUSTON
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State | TX
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Zip | 77288-8411
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Country | US
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Telephone | 832-835-1442
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Fax | 832-369-1761
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Authorized Official
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Title or Position | RMA, ADMINISTRATION ASSISTANT
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Name | KAY GREENBERG
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Credential | RMA
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Telephone | 832-835-1442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | TX-2031
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License Number State | TX
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