Organization Active NPI

Fulshear Foot and Ankle PLLC

  • Podiatrist
  • Fulshear, TX
National Provider Identifier
1811369341
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FULSHEAR FOOT AND ANKLE PLLC
Practice address
7609 Tiki Dr Ste D
Fulshear, TX 77441-1678
Phone
(281) 391-1212
NPI assigned
Oct 23, 2015
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Jeanna Michelle Mascorro
Title
DPM
Phone
(281) 391-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

7609 Tiki Dr Ste D
Fulshear, TX 77441-1678

Mailing address

7609 Tiki Dr Ste D
Fulshear, TX 77441-1678
Phone (281) 391-1212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151026000289 TX DME Supplier - Physician - Podiatry 6103130935 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fulshear, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7609 Tiki Dr
Ste D
Fulshear, TX 77441
Phone (281) 391-1212

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1811369341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 TIKI DR STE D",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774411678",
            "telephone_number": "281-391-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 TIKI DR STE D",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774411678",
            "telephone_number": "281-391-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULSHEAR FOOT AND ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "MASCORRO",
        "authorized_official_first_name": "JEANNA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "281-391-1212"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulshear, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.