Organization
FOOT PAIN RELIEF STORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LI-DA HUANG PH.D. (PRESIDENT/OWNER)
(512) 374-0818
Entity
Organization
Contact information
Practice address
7801 N LAMAR, SUITE C59, AUSTIN, TX 78752-1028
(512) 374-0818
(512) 374-0810
Mailing address
7801 N LAMAR, SUITE C59, AUSTIN, TX 78752-1028
(512) 374-0818
(512) 374-0810
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531408
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/25/2006
Last updated
01/27/2017
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