Organization
S. F. HARTLEY, D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY FRED HARTLEY D.P.M. (OWNER/ PRACTIONER)
28147985311
Entity
Organization
Contact information
Practice address
112 W PASADENA BLVD, DEER PARK, TX 77536-4870
(281) 479-5311
(281) 479-0748
Mailing address
112 W PASADENA BLVD, DEER PARK, TX 77536-4870
(281) 479-5311
(281) 479-0748
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0691
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F38E
BC/BS OF TEXAS
TX
01
—
82J977
BC/BS OF TEXAS
TX
Enumeration date
08/13/2007
Last updated
10/30/2007
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