Provider Demographics
NPI:1376570549
Name:RICHARD VEGLIA DPM PC
Entity Type:Organization
Organization Name:RICHARD VEGLIA DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST PRESIDENT OF CORP
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-924-0516
Mailing Address - Street 1:1512 PLEASANTON ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1146
Mailing Address - Country:US
Mailing Address - Phone:210-924-0516
Mailing Address - Fax:210-924-0166
Practice Address - Street 1:1512 PLEASANTON ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1146
Practice Address - Country:US
Practice Address - Phone:210-924-0516
Practice Address - Fax:210-924-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092838401Medicaid
TXTXB141855Medicare PIN
TX092838401Medicaid