MEDICARE: PARK PLAZA FOOT SPECIALISTS PC

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	0789	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8K1283	OTHER	TX	BCBS
2	4303065	OTHER	TX	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588747265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARK PLAZA FOOT SPECIALISTS PC

Provider Business Mailing Address
First Line	:	1200 BINZ ST
Second Line	:	#1275
City	:	HOUSTON
State	:	TX
Zip	:	77004-6937
Country	:	US
Telephone Number	:	713-529-1010
Fax Number	:	713-529-6454

Provider Business Practice Location Address
First Line	:	1200 BINZ ST
Second Line	:	#1275
City	:	HOUSTON
State	:	TX
Zip	:	77004-6937
Country	:	US
Telephone Number	:	713-529-1010
Fax Number	:	713-529-6454

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHERMAN NAGLER
Credential	:	DPM
Telephone Number	:	713-529-1010

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	03/18/2014

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Directions to “PARK PLAZA FOOT SPECIALISTS PC ” Practice Location

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