Provider Demographics
NPI:1730971045
Name:BRAZOS FOOT & ANKLE LLC
Entity type:Organization
Organization Name:BRAZOS FOOT & ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPPINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:254-300-7703
Mailing Address - Street 1:2524 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7447
Mailing Address - Country:US
Mailing Address - Phone:254-300-7703
Mailing Address - Fax:254-300-7709
Practice Address - Street 1:2524 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7447
Practice Address - Country:US
Practice Address - Phone:254-300-7703
Practice Address - Fax:254-300-7709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric