MEDICARE: SOUTH TEXAS FOOT AND ANKLE DOCTORS

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	261QP1100X	Podiatric Clinic/Center
2	213E00000X	Podiatrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2175	OTHER	TX	PODIATRY

General Provider Information

NPI Number	:	1093223851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH TEXAS FOOT AND ANKLE DOCTORS

Provider Business Mailing Address
First Line	:	4413 N MCCOLL RD
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2464
Country	:	US
Telephone Number	:	956-682-8391
Fax Number	:	956-682-0018

Provider Business Practice Location Address
First Line	:	4420 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9608
Country	:	US
Telephone Number	:	267-324-4676
Fax Number	:	956-682-0018

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALI M ABDUL KAREEM
Credential	:	DPM
Telephone Number	:	267-324-4676

Provider Enumeration Date	:	01/16/2018
Last Update Date	:	12/21/2021

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