Basic Information
| Provider Information | |||||||||
| NPI: | 1205274339 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARNOLD J WOLF DPM | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ARNOLD J WOLF DPM INC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7707 FANNIN ST | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770541926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137979999 | ||||||||
| FaxNumber: | 7137976503 | ||||||||
| Practice Location | |||||||||
| Address1: | 7707 FANNIN ST | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770541926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137979999 | ||||||||
| FaxNumber: | 7137976503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2013 | ||||||||
| LastUpdateDate: | 06/11/2013 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WOLF | ||||||||
| AuthorizedOfficialFirstName: | ARNOLD | ||||||||
| AuthorizedOfficialMiddleName: | JEROME | ||||||||
| AuthorizedOfficialTitleorPosition: | PODIATRIST FOOT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 7137979999 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DPM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213ES0103X | Y | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.