Provider Demographics
NPI:1396846341
Name:THE PODIATRY GROUP OF SOUTH TEXAS, PA
Entity Type:Organization
Organization Name:THE PODIATRY GROUP OF SOUTH TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-227-8700
Mailing Address - Street 1:5825 CALLAGHAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1106
Mailing Address - Country:US
Mailing Address - Phone:210-227-8700
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:11901 TOEPPERWEIN RD STE 1102
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3159
Practice Address - Country:US
Practice Address - Phone:210-650-0314
Practice Address - Fax:210-654-1783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4986670010Medicare NSC