Organization
FOOT CLINIC OF EAST TEXAS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT D PHELPS DPM (OWNER/DPM)
(903) 593-0987
Entity
Organization
Contact information
Practice address
1108 S BUFFALO ST, CANTON, TX 75103-2304
(903) 593-0987
(903) 592-3309
Mailing address
1828 E SOUTHEAST LOOP 323 STE 111, TYLER, TX 75701-8314
(903) 593-0987
(903) 592-3309
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
L1636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001752916
UHC ID
TX
05
—
091707203
—
TX
Enumeration date
01/08/2010
Last updated
07/22/2024
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