MEDICARE: PURE FOOT AND ANKLE CENTER PLLC

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	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1528875994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE FOOT AND ANKLE CENTER PLLC

Provider Business Mailing Address
First Line	:	7703 BEECHNUT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-3101
Country	:	US
Telephone Number	:	821-263-1667
Fax Number	:

Provider Business Practice Location Address
First Line	:	7703 BEECHNUT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-3101
Country	:	US
Telephone Number	:	821-263-1667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NEDA MEHMANDOOST
Credential	:	DPM
Telephone Number	:	821-263-1667

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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