Organization Name: | SOUTH TEXAS FOOT SPECIALIST, PA |
NPI Number: | 1003954249 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TEENA G TRAHAN (MANAGER) |
Mailing Address: | 119 E Edgewood Dr Friendswood |
State: | TX US |
Postal Code: | 775463818 |
Phone Number: | 2819969546 |
Fax Number: | 2819967645 |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 213ES0103X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |