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Organization
MEYNARD M. NUSSBAUM DPM PA
Active
Organization
MEYNARD M. NUSSBAUM DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEYNARD MORRIE NUSSBAUM DPM PA (PRESIDENT)
(713) 781-0019
Entity
Organization
Contact information
Practice address
2500 FONDREN ROAD, SUITE 255, HOUSTON, TX 77063-2313
(713) 781-0019
(713) 781-1112
Mailing address
2500 FONDREN ROAD, SUITE 255, HOUSTON, TX 77063-2313
(713) 781-0019
(713) 781-1112
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0456
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018796501
—
TX
01
—
0456
TX MEDICAL LICENSE
TX
Enumeration date
12/17/2007
Last updated
10/14/2016
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