| NPI | 1982115259 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | REBEKAH DENISE FONTENOT Owner 281-910-7172 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2189) | 
| Enumeration Date | 2017-10-13 | 
| Last Update Date | 2018-09-10 |