MEDICARE: FOOT AND ANKLE CENTERS OF TEXAS, 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
1	213ES0103X	Foot & Ankle Surgery Podiatrist		TX

General Provider Information

NPI Number	:	1609911692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT AND ANKLE CENTERS OF TEXAS, PA

Provider Business Mailing Address
First Line	:	PO BOX 57310
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-7310
Country	:	US
Telephone Number	:	281-554-0111
Fax Number	:	281-332-1787

Provider Business Practice Location Address
First Line	:	1108 GULF FWY S STE 106
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-5100
Country	:	US
Telephone Number	:	281-554-0111
Fax Number	:	281-332-1787

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SEAN AZIZ REYHANI
Credential	:	D.P.M.
Telephone Number	:	281-554-0111

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	03/09/2021

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