MEDICARE: DR. DAVID SAMUEL WOLF D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	0359	TX
2	213E00000X	Podiatrist	0359	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	4269450001	OTHER	TX	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2815792006	OTHER	TX	CIGNA - PPO
2	2815792007	OTHER	TX	CIGNA - COM. HMO
4	1026570	OTHER	TX	AETNA #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	TN04	OTHER	TX	BCBS
7	28157	OTHER	TX	CIGNA - HMO
8	10014884	OTHER	TX	AMERIGROUP
9	23006	OTHER	TX	FIRST HEALTH
10	17079691	OTHER	TX	EVERCARE

General Provider Information

NPI Number	:	1376546051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SAMUEL WOLF D.P.M.

Provider Business Mailing Address
First Line	:	11515 CHIMNEY ROCK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-2905
Country	:	US
Telephone Number	:	713-728-3117
Fax Number	:	713-728-2212

Provider Business Practice Location Address
First Line	:	11515 CHIMNEY ROCK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-2905
Country	:	US
Telephone Number	:	713-728-3117
Fax Number	:	713-728-2212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/27/2015

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Directions to “ DR. DAVID SAMUEL WOLF D.P.M.” Practice Location

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