Provider Demographics
NPI:1992712160
Name:WEBB, DOUGLAS EDWARD JR (DPM)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:EDWARD
Last Name:WEBB
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MEDIC LN
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-5567
Mailing Address - Country:US
Mailing Address - Phone:281-331-3525
Mailing Address - Fax:281-331-9471
Practice Address - Street 1:400 MEDIC LN
Practice Address - Street 2:SUITE E
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5567
Practice Address - Country:US
Practice Address - Phone:281-331-3525
Practice Address - Fax:281-331-9471
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1297213E00000X, 213EP1101X, 213ER0200X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0926854OtherAETNA
TX0088CEOtherBLUE CROSS/BLUE SHIELD
TX092737802Medicaid
TX0926854OtherAETNA
TX0088CEOtherBLUE CROSS/BLUE SHIELD
TX092737802Medicaid