Individual provider Active NPI

David A. Hosack, D.P.M.

  • Foot Surgery Podiatrist
  • Lake Jackson, TX
National Provider Identifier
1548222318
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
P 1063 Issued in TX
Practice address
107 Circle Way St
Lake Jackson, TX 77566-5233
Phone
(979) 297-3204
Fax
(979) 297-6220
NPI assigned
Apr 5, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X P 1063 TX Primary

Addresses

Primary practice location

107 Circle Way St
Lake Jackson, TX 77566-5233

Mailing address

PO Box 783
Lake Jackson, TX 77566-0783
Phone (979) 297-3204

Other identifiers 1

IdentifierTypeStateIssuer
018624901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P 1063TXMDFoot Surgery Podiatrist

Interoperability endpoints

  • Direct secure messaging: dhosack456992@direct.stlukeshealth.org

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1548222318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775660783",
            "telephone_number": "979-297-3204",
            "fax_number": "979-297-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CIRCLE WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665233",
            "telephone_number": "979-297-3204",
            "fax_number": "979-297-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSACK",
        "first_name": "DAVID",
        "middle_name": "A.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TX",
            "license": "P 1063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018624901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.