MEDICARE: ANA URUKALO DPM

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	213E00000X	Podiatrist	1372	TX
2	213ES0131X	Foot Surgery Podiatrist	1372	TX
3	213ES0103X	Foot & Ankle Surgery Podiatrist	1372	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578520102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA URUKALO DPM

Provider Business Mailing Address
First Line	:	12221 MOPAC EXPRESSWAY NORTH
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-2483
Country	:	US
Telephone Number	:	512-901-4015
Fax Number	:	512-901-3935

Provider Business Practice Location Address
First Line	:	5145 N FM 620 BLDG I
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78732-1815
Country	:	US
Telephone Number	:	512-681-5900
Fax Number	:	512-681-5922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	01/20/2022

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Directions to “ ANA URUKALO DPM” Practice Location

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