Organization Name: | FOOT CENTER MCALLEN-WESLACO PLLC |
NPI Number: | 1043646037 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT C BRACE (OWNER) |
Mailing Address: | 107 W 6th St Weslaco |
State: | TX US |
Postal Code: | 785966033 |
Phone Number: | 9569691063 |
Fax Number: | 9569698372 |
NPI Enumeration Date: | 09/23/2013 |
NPI Last Update Date: | 09/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |