# EAST TEXAS PODIATRY ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225137185
- **Authorized official:** DR. ROBERT A BOUDREAU DPM (OWNER)
- **Authorized official phone:** (903) 593-1749

## Contact information

- **Practice address:** 1028 E IDEL, SUITE A, TYLER, TX 75701
- **Practice address phone:** (903) 593-1749
- **Practice address fax:** (903) 593-1487
- **Mailing address:** 1028 E IDEL, SUITE A, TYLER, TX 75701
- **Mailing address phone:** (903) 593-1749
- **Mailing address fax:** (903) 593-1487

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 03/03/2009