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Organization
FOOT SPECIALISTS OF TYLER, PA
Active
Organization
FOOT SPECIALISTS OF TYLER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES D RHODUS DPM (OWNER)
(903) 592-7200
Entity
Organization
Contact information
Practice address
649 S BROADWAY AVE, SUITE 2, TYLER, TX 75701-1602
(903) 592-7200
(903) 592-7211
Mailing address
649 S BROADWAY AVE, SUITE 2, TYLER, TX 75701-1602
(903) 592-7200
(903) 592-7211
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1375
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013PD
BCBS
TX
05
—
186188201
—
TX
01
—
DF6646
MEDICARE RAILROAD
TX
Enumeration date
02/12/2007
Last updated
11/13/2009
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