MEDICARE: THE PODIATRY GROUP OF SOUTH TEXAS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1083715056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PODIATRY GROUP OF SOUTH TEXAS, PA

Provider Business Mailing Address
First Line	:	5825 CALLAGHAN RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1106
Country	:	US
Telephone Number	:	210-227-8700
Fax Number	:	210-348-9130

Provider Business Practice Location Address
First Line	:	1303 MCCULLOUGH AVE STE 348
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-5622
Country	:	US
Telephone Number	:	210-227-4164
Fax Number	:	210-227-6708

Authorized Official
Title or Position	:	OPERATIONS OFFICER
Name	:	KAREN D SINCLAIR
Credential	:
Telephone Number	:	210-227-8700

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	04/18/2018

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