Provider Demographics
NPI:1861454837
Name:PRECISION PODIATRY PC
Entity Type:Organization
Organization Name:PRECISION PODIATRY PC
Other - Org Name:PRECISION PODIATRY PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RASHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKARD-RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-255-0125
Mailing Address - Street 1:7200 WYOMING SPGS STE 1150
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4310
Mailing Address - Country:US
Mailing Address - Phone:512-255-0125
Mailing Address - Fax:512-255-0153
Practice Address - Street 1:7200 WYOMING SPGS STE 1150
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-255-0125
Practice Address - Fax:512-255-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0047DEOtherPODIATRY
TX080945102Medicaid
TX0047DEOtherBCBS
TX0047DEOtherBCBS