Provider Demographics
NPI:1700808110
Name:WALTERS, STEVEN A (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:WALTERS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E 30TH ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3378
Mailing Address - Country:US
Mailing Address - Phone:512-477-8853
Mailing Address - Fax:512-477-2592
Practice Address - Street 1:900 EAST 30TH STREET
Practice Address - Street 2:SUITE 311
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3378
Practice Address - Country:US
Practice Address - Phone:512-477-8853
Practice Address - Fax:512-477-2592
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3106213ES0103X
TX1810213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV06121Medicare UPIN
U5566AMedicare ID - Type Unspecified
TX8F24083Medicare PIN