| NPI | 1184731531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON E. SLATE Medical Director/Owner 979-848-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2025-08-20 |