FOOT CLINIC OF EAST TEXAS, PC (NPI# 1457681785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457681785 |
| Entity Type | Organization |
| Organization Name | FOOT CLINIC OF EAST TEXAS, PC |
| Practice Address |
1108 S Buffalo St Canton TX 75103-2304 |
| Mailing Address |
321 S Fannin Ave Tyler TX 75702-7321 |
| Practice Telephone | 9035930987 |
| Practice Fax Number | 9035975618 |
| Mailing Telephone | 9035930987 |
| Mailing Fax Number | 9035975618 |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2012-06-11 |
| Authorized Official Name | DR. ROBERT D PHELPS (OWNER) |
| Authorized Official Telephone | 9035930987 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | L1636 | TX | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 091707202 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932439262 | Foot Clinic of East Texas, PC | Podiatrist | 711 E Goode St, Quitman, TX 75783-1623 | 2010-01-08 |
| 1114257441 | Foot Clinic of East Texas, PC | Podiatrist | 612 Maryland Dr, Athens, TX 75751-3332 | 2010-01-08 |
| 1790015022 | Foot Clinic of East Texas, PC | Podiatrist | 2001 S Henderson Blvd, Kilgore, TX 75662-3556 | 2010-01-08 |
| 1760712095 | Foot Clinic of East Texas, PC | Podiatrist | 1101 S Main St, Lindale, TX 75771-6266 | 2010-01-08 |
| Street Address |
1108 S BUFFALO ST |
| City | CANTON |
| State | TX |
| Zip Code | 75103-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073598199 | Jimmy W Dailey | Family Medicine | 1108 S Buffalo St, Canton, TX 75103-2304 | 2005-12-13 |
| 1619105442 | Dailey Medical Clinic | Family Medicine | 1108 S Buffalo St, Canton, TX 75103-2304 | 2009-07-01 |
| 1467564492 | Angela C Whitton | Physician Assistant | 1108 S Buffalo St, Canton, TX 75103-2304 | 2006-08-31 |
| 1609818053 | Dailey Medical Clinic | Family Medicine | 1108 S Buffalo St, Canton, TX 75103-2304 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265095202 | Brandi Jo Foster | Nurse Practitioner | 4437 Etheride Circle, Canton, TX 75103 | 2019-04-16 |
| 1124595087 | Melissa Williams | Nurse Practitioner | 1108 So. Buffalo St, Canton, TX 75103 | 2018-10-30 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1568945921 | Kelsey Lauren Nixon | Registered Nurse | 5640 Vzcr 4106, Canton, TX 75103 | 2018-09-12 |
| 1649770496 | Chelsea Boshart | Registered Nurse | 150 Vz Cr 4130, Canton, TX 75103 | 2018-02-19 |
| 1396292918 | Deanne Wheeler | Hearing Instrument Specialist | 150 E. Dallas Street, Canton, TX 75103 | 2016-09-01 |
| 1356701221 | Betsy Jill Chappell | Nurse Practitioner | 406 Tx-243, Canton, TX 75103 | 2016-03-04 |
| 1326435199 | Forever Kids Pediatric Clinic | Clinic/Center | 182 Privatet Road 6413, Canton, TX 75103 | 2015-04-20 |
| 1417255233 | Dallas County Hospital District | Skilled Nursing Facility | 1901 S Trade Days Blvd, Canton, TX 75103 | 2011-03-02 |
| 1922243906 | Brookshire Grocery Company | Pharmacy | 880 E State Highway 243, Canton, TX 75103 | 2008-12-05 |
| Find all providers in zip 75103 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053887869 | Canton Podiatry Pllc | Podiatrist | 42017 Ford Rd, Canton, MI 48187-3669 | 2018-10-18 |
| 1083008221 | Donald A Leright Dpm Pllc | Podiatrist | 46036 Michigan Ave, Suite 286, Canton, MI 48188-2304 | 2015-03-25 |
| 1023458304 | Evan Michael Lewis | Podiatrist | 147 Reinhardt College Pkwy Ste 10, Canton, GA 30114-5295 | 2013-07-01 |
| 1881858959 | Connecticut Foot Specialists PC | Podiatrist | 259 Albany Turnpike, Suite C, Canton, CT 06019 | 2008-07-17 |
| 1457562175 | Janay L Harper Dpm Pllc | Podiatrist | 156 River Oaks Dr Ste B, Canton, MS 39046-5376 | 2007-05-24 |
| 1790868826 | Hon W Fong Dpm Pllc | Podiatrist | 2050 N Haggerty Rd Ste 120, Canton, MI 48187-3796 | 2006-10-23 |
| 1871675009 | George Madson Kemper Jr. | Podiatrist | 5454 Fulton Dr Nw, Canton, OH 44718-1727 | 2006-10-19 |
| 1215027420 | Robert I Lubin | Podiatrist | 8552 N Canton Center Rd, Canton, MI 48187-1310 | 2006-10-16 |
| 1750477493 | Thomas Richard Nystrom | Podiatrist | 80 East Main St, Canton, NY 13617 | 2006-10-04 |
| 1982795365 | Canton Podaitry Associates | Podiatrist | 742 Washington St, Canton, MA 02021-3039 | 2006-09-28 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.