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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