| NPI | 1194178608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS SCOTT BODEKER Owner 281-973-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2147) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2017-01-13 |