Executive Sole Podiatry, PLLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

EXECUTIVE SOLE PODIATRY, PLLC

Practice address

5373 W Alabama St Ste 204
Houston, TX 77056-5923

Phone

(866) 925-5662

Fax

(866) 925-5662

NPI assigned

Jul 21, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anetra Sharice Miranda, DPMNPI 1871770917

Title

Podiatrist

Phone

(866) 925-5662

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anetra Sharice Miranda, DPM

  • Foot & Ankle Surgery Podiatrist
  • Houston, TX
  • NPI 1871770917
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1053929430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6445 FM 1463 RD STE 160-213",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774944027",
            "telephone_number": "866-925-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 W ALABAMA ST STE 204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770565923",
            "telephone_number": "866-925-5662",
            "fax_number": "866-925-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE SOLE PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "ANETRA",
        "authorized_official_middle_name": "SHARICE",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "866-925-5662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HIPPOCRATE.ORG",
            "affiliation": "N",
            "address_1": "27311 Symphony Creek Ln",
            "city": "Fulshear",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774411427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Podiatric Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Podiatric Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.