Organization Active NPI

Meynard M. Nussbaum DPM PA

  • Podiatrist
  • Houston, TX
National Provider Identifier
1992988661
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0456 Issued in TX
Legal business name
MEYNARD M. NUSSBAUM DPM PA
Practice address
2500 Fondren Road
Suite 255
Houston, TX 77063-2313
Phone
(713) 781-0019
Fax
(713) 781-1112
NPI assigned
Dec 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Meynard Morrie Nussbaum, DPM PA
Title
President
Phone
(713) 781-0019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 0456 TX Primary

Addresses

Primary practice location

2500 Fondren Road
Suite 255
Houston, TX 77063-2313

Mailing address

2500 Fondren Road
Suite 255
Houston, TX 77063-2313
Phone (713) 781-0019

Other identifiers 2

IdentifierTypeStateIssuer
018796501MedicaidTX
0456OtherTXTX MEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

2500 Fondren Rd
Ste 310
Houston, TX 77063
Phone (713) 557-0469

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1992988661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FONDREN ROAD",
            "address_2": "SUITE 255",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770632313",
            "telephone_number": "713-781-0019",
            "fax_number": "713-781-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FONDREN ROAD",
            "address_2": "SUITE 255",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770632313",
            "telephone_number": "713-781-0019",
            "fax_number": "713-781-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEYNARD M. NUSSBAUM DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "MEYNARD",
        "authorized_official_middle_name": "MORRIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-781-0019",
        "authorized_official_credential": "DPM PA"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "0456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018796501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "0456",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.