Provider Demographics
NPI:1003901489
Name:DEL RIO FOOT CLINIC P.A.
Entity Type:Organization
Organization Name:DEL RIO FOOT CLINIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-872-3668
Mailing Address - Street 1:94 BRIGGS ST STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1272
Mailing Address - Country:US
Mailing Address - Phone:210-872-3668
Mailing Address - Fax:210-428-6317
Practice Address - Street 1:94 BRIGGS ST STE 600
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1272
Practice Address - Country:US
Practice Address - Phone:210-872-3668
Practice Address - Fax:210-428-6317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0043CGOtherBLUE CROSS BLUE SHIELD
CK5717OtherMEDICARE RAILROAD
TX079633601Medicaid
0043CGOtherBLUE CROSS BLUE SHIELD