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General NPI Number Information
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NPI Number | 1417515057
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Entity Type | Organization
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Legal Business Name | BEXARFOOT PODIATRY PLLC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 4334 N LOOP 1604 W STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3485
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Country | US
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Telephone | 210-540-4205
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 690833
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City | SAN ANTONIO
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State | TX
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Zip | 78269-0833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/HEALTH CARE PROVIDER
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Name | DR. ELAINE DANIAL
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Credential | DPM
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Telephone | 210-540-4205
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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 |
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License Number State |
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