Provider Demographics
NPI:1942330220
Name:RICHARD EUSANIO, D.P.M.,P.C.
Entity Type:Organization
Organization Name:RICHARD EUSANIO, D.P.M.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EUSANIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-270-3338
Mailing Address - Street 1:1645 N TOWN EAST BLVD
Mailing Address - Street 2:#502
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4158
Mailing Address - Country:US
Mailing Address - Phone:972-270-3338
Mailing Address - Fax:972-270-7882
Practice Address - Street 1:1645 N TOWN EAST BLVD
Practice Address - Street 2:#502
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4158
Practice Address - Country:US
Practice Address - Phone:972-270-3338
Practice Address - Fax:972-270-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0440213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A3885Medicare PIN