MEDICARE: TEXAN FOOT CARE CLINIC, PLLC

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	2269	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	:	1942789995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAN FOOT CARE CLINIC, PLLC

Provider Business Mailing Address
First Line	:	1315 ST JOSEPH PKWY STE 301
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8229
Country	:	US
Telephone Number	:	346-204-5528
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY STE 301
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8229
Country	:	US
Telephone Number	:	346-204-5528
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. YERMESHA L KYLE
Credential	:	D.P.M.
Telephone Number	:	832-244-0373

Provider Enumeration Date	:	08/10/2018
Last Update Date	:	12/20/2018

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