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General NPI Number Information
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NPI Number | 1992816912
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Entity Type | Organization
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Legal Business Name | SOUTH AUSTIN FOOT ASSOCIATES PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 5656 BEE CAVES RD STE D204
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5236
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Country | US
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Telephone | 512-447-2025
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Fax | 512-447-4968
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Provider Business Mailing Address
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Address Line | 5656 BEE CAVES RD STE D204
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5236
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Country | US
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Telephone | 512-447-2025
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Fax | 512-447-4968
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS L BERGER
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Credential | DPM
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Telephone | 512-447-2025
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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 | 0709
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0823
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License Number State | TX
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