Organization
FOOT AND ANKLE CENTER OF NORTH HOUSTON P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE S MACTAVISH D.P.M. (PRESIDENT/PHYSICIAN)
(281) 444-4114
Entity
Organization
Contact information
Practice address
17215 RED OAK DR, SUITE 102, HOUSTON, TX 77090-2697
(281) 444-4114
(281) 453-1269
Mailing address
17215 RED OAK DR, SUITE 102, HOUSTON, TX 77090-2697
(281) 444-4114
(281) 453-1269
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026DE
BCBS
TX
05
—
081189501
—
TX
Enumeration date
06/12/2006
Last updated
10/20/2009
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