Provider Demographics
NPI:1851020820
Name:SAN ANTONIO PODIATRY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SAN ANTONIO PODIATRY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VP
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANZALDUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-899-1026
Mailing Address - Street 1:12450 NETWORK BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3466
Mailing Address - Country:US
Mailing Address - Phone:210-899-1026
Mailing Address - Fax:
Practice Address - Street 1:14615 SAN PEDRO AVE STE 160
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4364
Practice Address - Country:US
Practice Address - Phone:210-899-1026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN ANTONIO PODIATRY ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty