Healthy Feet Store

LBN: Reality Foot Care Llc
Healthy Feet Store is an health care organization with primary practice located at 2921 Lackland Rd Suite 101, Fort Worth TX 76116-4173. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Reality Foot Care Llc can be contacted via phone (817) 377-3668, or through Black, Teresa Ann via phone (817) 377-3668.

Contact Information

Primary practice address
2921 Lackland Rd Suite 101 Fort Worth TX 76116-4173
Phone: (817) 377-3668
Fax: (817) 377-2646
Website:
Map and Directions
Authorized official contact:
Name: Black, Teresa Ann C PED
Phone: (817) 377-3668

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X CPED1950 Texas

Profile Details

NPI number 1447427562
LBN Legal business name Reality Foot Care Llc
DBA Doing business as Healthy Feet Store
Authorized official Black, Teresa Ann C PED
Entity Organization
Organization subpart 1 No
Enumeration date May 8th, 2008
Last updated Nov 15th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447427562 NPPES
Texas MEDICAID 010258401

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