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General NPI Number Information
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NPI Number | 1780126334
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Entity Type | Organization
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Legal Business Name | THE FOOT AND ANKLE ASSOCIATES OF TEXAS, PLLC
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 509 W TIDWELL RD 110
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City | HOUSTON
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State | TX
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Zip | 77091-4352
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Country | US
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Telephone | 281-974-3177
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Fax |
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Provider Business Mailing Address
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Address Line | 509 W TIDWELL RD 110
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City | HOUSTON
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State | TX
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Zip | 77091-4352
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Country | US
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Telephone | 281-974-3177
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | OLUWATOSIN OGUNLANA
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Credential | DPM
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Telephone | 281-974-3177
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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 | 2063
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License Number State | TX
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