MEDICARE: BEXARFOOT PODIATRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1417515057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEXARFOOT PODIATRY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 690833
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78269-0833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4334 N LOOP 1604 W STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3485
Country	:	US
Telephone Number	:	210-540-4205
Fax Number	:

Authorized Official
Title or Position	:	OWNER/HEALTH CARE PROVIDER
Name	:	DR. ELAINE DANIAL
Credential	:	DPM
Telephone Number	:	210-540-4205

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	08/02/2019

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