EAST TEXAS FOOT ASSOCIATES NPI 1114086659

NPI Information

  • NPI: 1114086659
  • Provider Name: EAST TEXAS FOOT ASSOCIATES
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • CLIA Number: 45D2166122
  • Address: 200 S. JOHN REDDITT DR.
    LUFKIN, TX
    ZIP 75904
  • Phone: (936) 632-5252

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NPI Details

EAST TEXAS FOOT ASSOCIATES is a podiatrist in Lufkin, TX. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. EAST TEXAS FOOT ASSOCIATES NPI is 1114086659. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

200 S. JOHN REDDITT DR.
LUFKIN, TX
ZIP 75904
Phone: (936) 632-5252
Fax: (936) 632-5284

The provider's authorized official is Eddy Gene Corse .
The authorized official title is Dpm and has the following contact phone number (936) 632-5252.

The CLIA number assigned to this NPI record is 45D2166122 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/8/2006 and was last updated on 11/7/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist0540TEXASYes
2213E00000XPodiatrist1590TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
114HZOTHERBCBS
200554TMEDICARE ID-TYPE UNSPECIFIED
3151320201MEDICAIDTEXAS
40807820001MEDICARE NSCTEXAS
5X72489MEDICARE UPIN
6373459201MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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