Healthcare Provider Details

I. General information

NPI: 1568036556
Provider Name (Legal Business Name): RIDDHI YAGNIK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RIDDHI YAGNIK DPM

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US

IV. Provider business mailing address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-7710
  • Fax: 210-358-7707
Mailing address:
  • Phone: 201-358-5909
  • Fax: 210-358-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number692180
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: