MEDICARE: L R ANTHON DPM A PROFESSIONAL CORPORATION

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	1813	TX

General Provider Information

NPI Number	:	1639345457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L R ANTHON DPM A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	58 ARBOR BEND DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 ARBOR BEND DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4331
Country	:	US
Telephone Number	:	800-626-2468
Fax Number	:	951-272-9924

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. LARRY R ANTHON
Credential	:	DPM
Telephone Number	:	800-626-2468

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	02/27/2012

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