Provider Demographics
NPI:1841452331
Name:LAREDO FAMILY FOOT CENTER, D.P.M., P.A.
Entity type:Organization
Organization Name:LAREDO FAMILY FOOT CENTER, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, PA
Authorized Official - Phone:956-712-3338
Mailing Address - Street 1:1105 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5258
Mailing Address - Country:US
Mailing Address - Phone:956-712-3338
Mailing Address - Fax:956-791-1951
Practice Address - Street 1:1105 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5258
Practice Address - Country:US
Practice Address - Phone:956-712-3338
Practice Address - Fax:956-791-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1222213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089812401Medicaid
TX00L96NMedicare PIN