MEDICARE: ELIAS R CHELEUITTE 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	1631	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
2	8A6976	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1972594455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIAS R CHELEUITTE DPM

Provider Business Mailing Address
First Line	:	5825 CALLAGHAN RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1106
Country	:	US
Telephone Number	:	210-227-8700
Fax Number	:	210-348-9130

Provider Business Practice Location Address
First Line	:	1303 MCCULLOUGH AVE STE 440
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-5606
Country	:	US
Telephone Number	:	210-227-4164
Fax Number	:	210-227-6708

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	02/13/2024

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