Provider Demographics
NPI:1508046996
Name:ALEX J. URTEAGA, D.P.M,P.A.
Entity Type:Organization
Organization Name:ALEX J. URTEAGA, D.P.M,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:J
Authorized Official - Last Name:URTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:830-625-8200
Mailing Address - Street 1:614C S BUSINESS IH 35 STE 82
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4795
Mailing Address - Country:US
Mailing Address - Phone:830-625-8200
Mailing Address - Fax:
Practice Address - Street 1:1528 E COMMON ST
Practice Address - Street 2:STE 18
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3337
Practice Address - Country:US
Practice Address - Phone:830-625-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1275213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155511201Medicaid
TX0073HVOtherBCBS
TX0073HVOtherBCBS
TX00673TMedicare PIN