MEDICARE: DR. RICHARD A BELLACOSA 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	213ES0103X	Foot & Ankle Surgery Podiatrist	0831	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	:	1700802576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD A BELLACOSA DPM

Provider Business Mailing Address
First Line	:	8042 WURZBACH RD
Second Line	:	440
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3818
Country	:	US
Telephone Number	:	210-692-9203
Fax Number	:	210-692-0028

Provider Business Practice Location Address
First Line	:	14615 SAN PEDRO AVE
Second Line	:	160
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4321
Country	:	US
Telephone Number	:	210-490-1871
Fax Number	:	210-490-1878

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/09/2007

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