Provider Demographics
NPI:1174513949
Name:WOLF, ARNOLD JEROME (DPM)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:JEROME
Last Name:WOLF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 FANNIN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1926
Mailing Address - Country:US
Mailing Address - Phone:713-797-9999
Mailing Address - Fax:713-797-6503
Practice Address - Street 1:7707 FANNIN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1926
Practice Address - Country:US
Practice Address - Phone:713-797-9999
Practice Address - Fax:713-797-6503
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0340213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0186843-01Medicaid
T16714Medicare UPIN
TX0186843-01Medicaid