Provider Demographics
NPI:1457069403
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 VICE PRESIDENT - TEXAS
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:TREECE
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 1:1180 SETON PKWY STE 300
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6179
Practice Address - Country:US
Practice Address - Phone:737-286-9009
Practice Address - Fax:737-286-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty