MEDICARE: JEFF SPOEDE HENKE DPM

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	1769	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871539007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFF SPOEDE HENKE DPM

Provider Business Mailing Address
First Line	:	135 BUNTON CREEK RD STE 300
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-5701
Country	:	US
Telephone Number	:	512-268-3668
Fax Number	:	512-268-5785

Provider Business Practice Location Address
First Line	:	135 BUNTON CREEK RD STE 300
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-5701
Country	:	US
Telephone Number	:	512-268-3668
Fax Number	:	512-268-5785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	01/28/2017

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Directions to “ JEFF SPOEDE HENKE DPM” Practice Location

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