Provider Demographics
NPI:1609869486
Name:CORRAL, OSCAR LUIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:LUIS
Last Name:CORRAL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:812 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-971-9107
Mailing Address - Fax:956-971-9109
Practice Address - Street 1:812 LINDBERG AVE
Practice Address - Street 2:COMPLETE FAMILY FOOT CARE
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-971-9107
Practice Address - Fax:956-971-9109
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1761213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183306301Medicaid
TX4661430001OtherPALMETTO DME FACILITY GROUP
TX1609869486OtherNPI INDIVIDUAL
TX4661430001OtherPALMETTO DME FACILITY GROUP
TX183306301Medicaid