Foot Clinic of East Texas PC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

FOOT CLINIC OF EAST TEXAS PC

Practice address

1828 E Southeast Loop 323 Ste 111
Tyler, TX 75701-8314

Phone

(903) 593-0987

Fax

(903) 592-3309

NPI assigned

Apr 13, 2006

Last updated

May 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Daniel Phelps, DPMNPI 1881689560

Title

Owner/DPM

Phone

(903) 593-0987

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Daniel Phelps, DPM

  • Podiatrist
  • Tyler, TX
  • NPI 1881689560
  Medicare reassignment NPD Authorized official
• Kati Elizabeth Waters, D.P.M.

  • Podiatrist
  • Tyler, TX
  • NPI 1437693330
  Medicare reassignment NPD
• CHI T Vu, P.A.

  • Medical Physician Assistant
  • Dallas, TX
  • NPI 1881994168
  NPD
• Paul Clint Jones, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Portland, OR
  • NPI 1174519359
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1184688566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 E SOUTHEAST LOOP 323 STE 111",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018314",
            "telephone_number": "903-593-0987",
            "fax_number": "903-592-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 E SOUTHEAST LOOP 323 STE 111",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018314",
            "telephone_number": "903-593-0987",
            "fax_number": "903-592-3309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 S Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "TX",
            "postal_code": "751032304",
            "country_code": "US",
            "telephone_number": "903-593-0987",
            "fax_number": "903-592-3309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOT CLINIC OF EAST TEXAS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/DPM",
        "authorized_official_telephone_number": "903-593-0987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091707203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Floyd
• Flynn Chiropractic PC (East Texas Doctors of Chiropractic)
• David Carroll Flynn, D.C.
• Megan Renee Followwell, PA-C
• Daniel Rush Folmer, LPC
• Foot Specialists of Tyler, PA
• Foot Specialists of Tyler, PA
• Gerald P Foox, MD
• Ginger L Forbus
• Valery Forcha, PHARM.D

• Podiatrist in Tyler, TX
• Providers in Tyler, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.