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NPI Code Detail

MEDICARE: MOORE FOOT AND ANKLE SPECIALISTS PA

MEDICARE: MOORE FOOT AND ANKLE SPECIALISTS 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
1213ES0103XFoot & Ankle Surgery Podiatrist
2213ES0000XSports Medicine Podiatrist
3213EP1101XPrimary Podiatric Medicine Podiatrist
4213ES0131XFoot Surgery Podiatrist
5213E00000XPodiatrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17771805OTHERTXAETNA ID

General Provider Information

NPI Number : 1588600241
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOORE FOOT AND ANKLE SPECIALISTS PA
Provider Business Mailing Address
First Line : 2616 FM 2920 RD STE N
Second Line :
City : SPRING
State : TX
Zip : 77388-3590
Country : US
Telephone Number : 281-444-6300
Fax Number : 832-375-1247
Provider Business Practice Location Address
First Line : 2616 FM 2920 RD STE N
Second Line :
City : SPRING
State : TX
Zip : 77388-3590
Country : US
Telephone Number : 281-444-6300
Fax Number : 832-375-1247
Authorized Official
Title or Position : CREDENTIALING SUPERVISOR
Name : TATIANA TORRES
Credential :
Telephone Number : 813-400-1140
Provider Enumeration Date : 06/21/2006
Last Update Date : 12/19/2025

Similar Medicare Providers

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1588241772 — SHANIKA A. MCCRAY DPM
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1659421394 — LAWRENCE ALAN KELMENSON MD
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Directions to “MOORE FOOT AND ANKLE SPECIALISTS PA ” Practice Location

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