Provider Demographics
NPI:1225210990
Name:BEXARFOOT CARE, PA
Entity Type:Organization
Organization Name:BEXARFOOT CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:817-426-5088
Mailing Address - Street 1:206 NE WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4117
Mailing Address - Country:US
Mailing Address - Phone:817-426-5088
Mailing Address - Fax:817-426-5089
Practice Address - Street 1:206 NE WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4117
Practice Address - Country:US
Practice Address - Phone:817-426-5088
Practice Address - Fax:817-426-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1648261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5161730001Medicare NSC
00604WMedicare PIN