Provider Demographics
NPI:1386833598
Name:TEXAS FOOT CONSULTANTS
Entity type:Organization
Organization Name:TEXAS FOOT CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-728-3117
Mailing Address - Street 1:11515 CHIMNEY ROCK ROAD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-2954
Mailing Address - Country:US
Mailing Address - Phone:713-728-3117
Mailing Address - Fax:713-728-2212
Practice Address - Street 1:11515 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-2954
Practice Address - Country:US
Practice Address - Phone:713-728-3117
Practice Address - Fax:713-728-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0359213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080071601Medicaid
TX0012CVOtherBCBS
TX0012CVOtherBCBS
TX00175KMedicare PIN
TX4269450001Medicare NSC