Healthcare Provider Details

I. General information

NPI: 1487965166
Provider Name (Legal Business Name): SOUTH TEXAS LIMB & WOUND CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 S ALAMEDA ST
CORPUS CHRISTI TX
78404-2506
US

IV. Provider business mailing address

3130 S ALAMEDA ST
CORPUS CHRISTI TX
78404-2506
US

V. Phone/Fax

Practice location:
  • Phone: 361-884-3984
  • Fax: 361-884-3986
Mailing address:
  • Phone: 361-884-3984
  • Fax: 361-884-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1226
License Number StateTX

VIII. Authorized Official

Name: DR. AL KLINE
Title or Position: OWNER
Credential: DPM
Phone: 361-884-3984