Provider Demographics
NPI:1093223851
Name:SOUTH TEXAS FOOT AND ANKLE DOCTORS
Entity Type:Organization
Organization Name:SOUTH TEXAS FOOT AND ANKLE DOCTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABDUL KAREEM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:267-324-4676
Mailing Address - Street 1:4413 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2464
Mailing Address - Country:US
Mailing Address - Phone:956-682-8391
Mailing Address - Fax:956-682-0018
Practice Address - Street 1:4420 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9608
Practice Address - Country:US
Practice Address - Phone:267-324-4676
Practice Address - Fax:956-682-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2175OtherPODIATRY