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General NPI Number Information
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NPI Number | 1780776963
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Entity Type | Individual
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Provider Name | LUIS R. VENEGAS DPM PA
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 40 MARSELLA BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3579
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Country | US
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Telephone | 956-574-9733
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Fax | 956-574-9730
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Provider Business Mailing Address
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Address Line | 5493 RUSTIC MANOR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3920
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Country | US
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Telephone | 956-574-9733
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Fax | 956-574-9730
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PO1452
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License Number State | TX
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