Reality Foot Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CPED1950 Issued in TX

Legal business name

REALITY FOOT CARE LLC

Practice address

2921 Lackland Rd
Suite 101
Fort Worth, TX 76116-4173

Phone

(817) 377-3668

Fax

(817) 377-2646

NPI assigned

May 8, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Teresa Ann Black, C PED

Title

Owner

Phone

(817) 377-3668

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HEALTHY FEET STORE Former legal business name

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1447427562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 LACKLAND RD",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761164173",
            "telephone_number": "817-377-3668",
            "fax_number": "817-377-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 LACKLAND RD",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761164173",
            "telephone_number": "817-377-3668",
            "fax_number": "817-377-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALITY FOOT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-377-3668",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C PED"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "CPED1950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010258401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHY FEET STORE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Miranda Reagan, MS, RD, LD
• Real Smiles
• Kelly Real, PT
• Kevin Daniel Real, MD
• Realign Health and Wellness Center
• Nanda S Reamy, RN
• Kristina Leah Reardon, CRNP
• Ryan Scott Reardon, M.D.
• Marta Elena Reasoner, LCSW
• Tiffany Taylor Reasons

• Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.