MEDICARE: ASTRO FOOT CARE 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	213E00000X	Podiatrist	1071	TX

General Provider Information

NPI Number	:	1841276557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTRO FOOT CARE PA

Provider Business Mailing Address
First Line	:	2309 BLODGETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5254
Country	:	US
Telephone Number	:	713-661-3393
Fax Number	:	713-661-3394

Provider Business Practice Location Address
First Line	:	2309 BLODGETT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5254
Country	:	US
Telephone Number	:	713-661-3393
Fax Number	:	713-661-3394

Authorized Official
Title or Position	:	CEO
Name	:	DR. TINA P OLIVER
Credential	:	DPM
Telephone Number	:	713-661-3393

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	01/02/2008

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Directions to “ASTRO FOOT CARE PA ” Practice Location

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