MEDICARE: FOOT SPECIALISTS OF TRI-COUNTY PA

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	261QP1100X	Podiatric Clinic/Center	1633P	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053503482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT SPECIALISTS OF TRI-COUNTY PA

Provider Business Mailing Address
First Line	:	119 MEDICAL CIR
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2138
Country	:	US
Telephone Number	:	903-885-2754
Fax Number	:	903-347-1207

Provider Business Practice Location Address
First Line	:	119 MEDICAL CIR
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2138
Country	:	US
Telephone Number	:	903-885-3754
Fax Number	:	903-347-1207

Authorized Official
Title or Position	:	PODIATRIST
Name	:	LANHUONG THI PHAM
Credential	:	DPM
Telephone Number	:	903-885-2754

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	09/01/2025

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