Bearfoot Shoes, LLC
Organization Active NPI Prosthetic/Orthotic Supplier · Granbury, TX
NPI 1871908194 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1871908194
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- Legal business name
- BEARFOOT SHOES, LLC
- Practice address
- 1205 Medical Plaza CT
Granbury, TX 76048 - Phone
- (817) 900-2250
- Fax
- (877) 757-5233
- NPI assigned
- Jun 25, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. John E Shero, C.PED
- Title
- President/Ceo
- Phone
- (817) 894-9436
Practitioners 1
-
John E Shero, CPED
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150612002176 | OK | DME Supplier - Medical Supply Company With Pedorthic Personnel |
7517287360 | Practice locations: Pryor, OK |
National Provider Directory
Locations
311 Westpark Way
Euless, TX 76040
Phone (682) 292-7349
300 S Morgan St
Ste 306
Granbury, TX 76048
Phone (682) 802-8721
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Yes |
Addresses
Primary practice location
1205 Medical Plaza CT
Granbury, TX 76048
Mailing address
1205 Medical Plaza CT
Granbury, TX 76048-5684
Phone (817) 900-2250
Other practice location 1
300 S Morgan St
suite 306
Granbury, TX 76048-1956
Phone (682) 802-8721
Other names
- Sports and Wellness, LLC
Other providers in Granbury, TX
- Gary Neal Barron
- Amanda Barstow
- Nicole Schrock Bartosh
- Baylor Surgicare at Granbury LLC
- Bayside Dermatology PA
- Latisha Beauchamp
- Lynn Beckler
- Dacodah Beech
- Tricia Dawn Beisch
- Belinda Tuck Counseling PLLC
All providers in Granbury, TX · Prosthetic/Orthotic Supplier in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.