MEDICARE: DR. DAVID JOHN SECORD 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	1412	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01362501	OTHER	TX	RAILROAD MEDICARE

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
3	2K4892	OTHER	TX	NOVITAS

General Provider Information

NPI Number	:	1801874763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOHN SECORD DPM

Provider Business Mailing Address
First Line	:	5350 S STAPLES ST
Second Line	:	SUITE 100
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-4682
Country	:	US
Telephone Number	:	361-888-8878
Fax Number	:	361-888-8815

Provider Business Practice Location Address
First Line	:	801 W 1ST ST
Second Line	:
City	:	SAN JUAN
State	:	TX
Zip	:	78589-2276
Country	:	US
Telephone Number	:	956-787-8915
Fax Number	:	956-787-2021

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

Provider Enumeration Date	:	01/02/2006
Last Update Date	:	09/30/2025

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Directions to “ DR. DAVID JOHN SECORD DPM” Practice Location

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