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General NPI Number Information
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NPI Number | 1174538623
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Entity Type | Organization
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Legal Business Name | PODIATRY OF CENTRAL TEXAS PA
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 701 MCCLINTIC DR
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City | GROESBECK
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State | TX
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Zip | 76642-2128
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Country | US
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Telephone | 800-957-9971
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Fax | 888-878-2856
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Provider Business Mailing Address
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Address Line | PO BOX 496
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City | HUBBARD
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State | TX
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Zip | 76648-0496
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Country | US
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Telephone | 800-957-9971
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Fax | 888-878-2856
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN DAVID BATTLES
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Credential | DPM
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Telephone | 800-957-9971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1771
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License Number State | TX
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