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General NPI Number Information
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NPI Number | 1447675970
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Entity Type | Organization
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Legal Business Name | LAWRENCE A CZELUSTA, DPM, PC
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9325 SCHOENTHAL RD
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City | SAN ANTONIO
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State | TX
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Zip | 78266-2858
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Country | US
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Telephone | 210-656-6383
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Fax | 210-651-9097
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Provider Business Mailing Address
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Address Line | 9325 SCHOENTHAL RD
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City | SAN ANTONIO
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State | TX
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Zip | 78266-2858
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Country | US
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Telephone | 210-656-6383
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Fax | 210-651-9097
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE A CZELUSTA
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Credential | D.P.M.
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Telephone | 210-656-6383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0633
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License Number State | TX
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