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Contact Information

BRAZOS VALLEY FOOT CARE PA
3312 LONGMIRE DR
COLLEGE STATION, TX77845-5812
 Phone: 979-776-6060
 Fax: 979-776-6172
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for BRAZOS VALLEY FOOT CARE PA · (Female)

NPI # 1194839563
Status Active
Credentials
Entity Individual
Enumeration date 08/19/2006
Last updated 01/17/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX Medicaid 080873501
  • TX Other 00613K BLUECROSSBLUESHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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