Provider Demographics
NPI:1578520102
Name:URUKALO, ANA (DPM)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:URUKALO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 MOPAC EXPRESSWAY NORTH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2483
Mailing Address - Country:US
Mailing Address - Phone:512-901-4015
Mailing Address - Fax:512-901-3935
Practice Address - Street 1:5145 N FM 620 BLDG I
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1815
Practice Address - Country:US
Practice Address - Phone:512-681-5900
Practice Address - Fax:512-681-5922
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1372213E00000X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039749901Medicaid
TXU73889Medicare UPIN
TX039749901Medicaid
TX480028985Medicare PIN