MEDICARE: PODIATRY OF CENTRAL 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	213ES0103X	Foot & Ankle Surgery Podiatrist	1771	TX

General Provider Information

NPI Number	:	1932346376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRY OF CENTRAL TEXAS, PA

Provider Business Mailing Address
First Line	:	PO BOX 496
Second Line	:
City	:	HUBBARD
State	:	TX
Zip	:	76648-0496
Country	:	US
Telephone Number	:	800-957-9971
Fax Number	:	888-878-2856

Provider Business Practice Location Address
First Line	:	1137 N LOOP 340
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76705-2486
Country	:	US
Telephone Number	:	800-957-9971
Fax Number	:	888-878-2856

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN DAVID BATTLES
Credential	:	DPM
Telephone Number	:	800-957-9971

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	03/30/2009

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