Provider Demographics
NPI:1366458887
Name:DOUGLAS E. WEBB DPM & ASSOCIATES P A
Entity type:Organization
Organization Name:DOUGLAS E. WEBB DPM & ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-331-3525
Mailing Address - Street 1:400 MEDIC LN
Mailing Address - Street 2:STE E
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-5567
Mailing Address - Country:US
Mailing Address - Phone:281-331-3525
Mailing Address - Fax:281-331-9471
Practice Address - Street 1:400 MEDIC LN
Practice Address - Street 2:STE E
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5567
Practice Address - Country:US
Practice Address - Phone:281-331-3525
Practice Address - Fax:281-331-9471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1297213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092737802Medicaid
TX0926854OtherAETNA
TX0088CEOtherBLUE CROSS/BLUE SHIELD
TX1222710002Medicare NSC
000126EMedicare PIN
TXU55680Medicare UPIN
TX000202EMedicare PIN