MEDICARE: FOOT SPA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1003795741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT SPA LLC

Provider Business Mailing Address
First Line	:	16902 MULBEN CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1847
Country	:	US
Telephone Number	:	832-206-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	11547 S HIGHWAY 6
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-4932
Country	:	US
Telephone Number	:	281-491-6095
Fax Number	:

Authorized Official
Title or Position	:	MARKETING MANAGER
Name	:	YIFEI GAO
Credential	:
Telephone Number	:	832-206-1075

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	01/28/2026

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Directions to “FOOT SPA LLC ” Practice Location

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