Healthcare Provider Details

I. General information

NPI: 1538471958
Provider Name (Legal Business Name): PODIATRY FIRST OF SAN ANTONIO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8142 NIGHT BLUFF DR
SAN ANTONIO TX
78255-3300
US

IV. Provider business mailing address

8142 NIGHT BLUFF DR
SAN ANTONIO TX
78255-3300
US

V. Phone/Fax

Practice location:
  • Phone: 210-845-4700
  • Fax: 210-451-7840
Mailing address:
  • Phone: 210-845-4700
  • Fax: 210-451-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number1918
License Number StateTX

VIII. Authorized Official

Name: DR. NI WILLIAMS
Title or Position: OWNER
Credential: D.P.M.
Phone: 210-845-4700