MEDICARE: FOOT SOLUTIONS MEMORIAL

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1467735480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT SOLUTIONS MEMORIAL

Provider Business Mailing Address
First Line	:	1560 ELDRIDGE PKWY STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1762
Country	:	US
Telephone Number	:	281-759-3668
Fax Number	:	281-493-2064

Provider Business Practice Location Address
First Line	:	1560 ELDRIDGE PKWY STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1762
Country	:	US
Telephone Number	:	281-759-3668
Fax Number	:	281-493-2064

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JIM SEPPALA
Credential	:
Telephone Number	:	281-759-3668

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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Directions to “FOOT SOLUTIONS MEMORIAL ” Practice Location

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