MEDICARE: COMFORT PODIATRY, 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	213EP1101X	Primary Podiatric Medicine Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DO6641	OTHER	TX	RAIL ROAD MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0034NC	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306022595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORT PODIATRY, PA

Provider Business Mailing Address
First Line	:	1151 N BUCKNER BLVD STE 304
Second Line	:	PROFESSIONAL BLDG. 1
City	:	DALLAS
State	:	TX
Zip	:	75218-3405
Country	:	US
Telephone Number	:	214-398-1234
Fax Number	:	214-398-1386

Provider Business Practice Location Address
First Line	:	1151 N BUCKNER BLVD STE 304
Second Line	:	PROFESSIONAL
City	:	DALLAS
State	:	TX
Zip	:	75218-3405
Country	:	US
Telephone Number	:	214-398-1234
Fax Number	:	214-398-1386

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. LUCY SCOTT
Credential	:
Telephone Number	:	214-398-1234

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	08/04/2010

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Directions to “COMFORT PODIATRY, PA ” Practice Location

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