Organization Active NPI

Sole Support Restorative Footwear, LLC

  • Durable Medical Equipment & Medical Supplies
  • Brenham, TX
National Provider Identifier
1275628323
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOLE SUPPORT RESTORATIVE FOOTWEAR, LLC
Practice address
905 E. Alamo Street
Brenham, TX 77833
Phone
(979) 421-9908
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Donna Steinbach
Title
Managing Member
Phone
(979) 421-9908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

905 E. Alamo Street
Brenham, TX 77833

Mailing address

905 E. Alamo Street
Brenham, TX 77833

Other identifiers 1

IdentifierTypeStateIssuer
531951OtherTXBLUE CROSS/BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

905 E Alamo St
Brenham, TX 77833
Phone (979) 421-9908

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275628323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 E. ALAMO STREET",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E. ALAMO STREET",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833",
            "telephone_number": "979-421-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLE SUPPORT RESTORATIVE FOOTWEAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEINBACH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "979-421-9908"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "531951",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.