Organization Active NPI

Advanced Foot and Ankle Specialist of Texas PLLC

  • Podiatrist
  • Richmond, TX
National Provider Identifier
1104381714
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ADVANCED FOOT AND ANKLE SPECIALIST OF TEXAS PLLC
Practice address
8919 Cypress Shrub TRL
Richmond, TX 77407-2007
Phone
(917) 365-1935
NPI assigned
Feb 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Dr. Christine Nguyen, DPMNPI 1396127767
Title
Doctor of Podiatric Medicine
Phone
(917) 365-1935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

8919 Cypress Shrub TRL
Richmond, TX 77407-2007

Mailing address

8919 Cypress Shrub TRL
Richmond, TX 77407-2007

Other identifiers 1

IdentifierTypeStateIssuer
1396127767MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190215001846 TX Part B Supplier - Clinic/Group Practice 3779821798 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, TX; Sugar Land, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1104381714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 CYPRESS SHRUB TRL",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8919 CYPRESS SHRUB TRL",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072007",
            "telephone_number": "917-365-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT AND ANKLE SPECIALIST OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-07",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "917-365-1935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396127767",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.