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FOOT CLINIC OF EAST TEXAS PC
NPI 1184688566
Podiatrist in Tyler, TX

Active since April 13, 2006
1828 E SOUTHEAST LOOP 323 STE 111, TYLER, TX 75701(903) 593-0987(903) 592-3309 Get Directions Write a Review

NPPES record last updated: May 13, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 13, 2024, Dec 3, 2020, Oct 17, 2018 (3 updates tracked since 2018).

About Foot Clinic Of East Texas Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOOT CLINIC OF EAST TEXAS PC (NPI 1184688566) is a healthcare organization registered as a podiatrist in Tyler, Texas and active in the NPI registry since April 2006. The organization maintains a secondary practice location in Canton and lists Robert Daniel Phelps, Owner/dpm, as its authorized official.

NPPES Registry Identity

NPI1184688566
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameFOOT CLINIC OF EAST TEXAS PC
Location Address1828 E SOUTHEAST LOOP 323 STE 111Tyler, TX 75701-8314
Mailing Address1828 E Southeast Loop 323 Ste 111Tyler, TX 75701-8314 · (903) 593-0987 · Fax (903) 592-3309
Phone(903) 593-0987
Fax(903) 592-3309
Organization SubpartNo
Authorized OfficialRobert Daniel PhelpsOwner/dpm · (903) 593-0987
Enumeration DateApril 13, 2006
Last NPPES UpdateMay 13, 20243 updates tracked since enumeration
NPPES CertifiedMay 13, 2024
✔ NPI 1184688566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Definition
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.
1828 E SOUTHEAST LOOP 323 STE 111, Tyler, TX 75701
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Secondary Practice Location 1

Location 11108 S Buffalo StCanton, TX 75103-2304 · Phone (903) 593-0987 · Fax (903) 592-3309

Other Identifiers 1

Medicaid091707203TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Foot Clinic Of East Texas Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Foot Clinic Of East Texas PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Robert Phelps, DPM
Podiatry
NPI 1881689560
1828 E SOUTHEAST LOOP 323 STE 111
Tyler, TX 75701
(903) 593-0987
✔ PECOS✔ Accepts MedicareSame address
Kati Waters, D.P.M.
Podiatry
NPI 1437693330
1761 TROUP HWY
Tyler, TX 75701
(903) 593-0987
✔ PECOS0.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Foot Clinic Of East Texas PC's NPI number?

The NPI number for Foot Clinic Of East Texas PC is 1184688566. It was assigned to this organization in the NPPES registry on April 13, 2006.

Where is Foot Clinic Of East Texas PC located?

Foot Clinic Of East Texas PC is located at 1828 E Southeast Loop 323 Ste 111, Tyler, TX 75701. The listed phone number is (903) 593-0987.

What is Foot Clinic Of East Texas PC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Foot Clinic Of East Texas PC enrolled in Medicare?

Yes. Foot Clinic Of East Texas PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Foot Clinic Of East Texas PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Podiatry, reassign their Medicare billing to Foot Clinic Of East Texas PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Foot Clinic Of East Texas PC was last updated on May 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.