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Contact Information

FOOT SPECIALISTS OF TYLER, PA
649 S BROADWAY AVE
SUITE 2
TYLER, TX75701-1602
 Phone: 903-592-7200
 Fax: 903-592-7211
 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 FOOT SPECIALISTS OF TYLER, PA

NPI # 1568504371
LBN Legal business name FOOT SPECIALISTS OF TYLER, PA
Authorized official CHARLES RHODUS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/12/2007
Last updated 11/13/2009 - About 17 years ago
Identifiers
TX License # 1375
TX Medicaid 186188201
TX Other 0013PD BCBS
TX Other DF6646 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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