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Contact Information

GULF COAST FOOT CLINIC PA
815 N VIRGINIA ST
PORT LAVACA, TX77979-3025
 Phone: 361-552-0295
 Fax: 361-582-0615
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GULF COAST FOOT CLINIC PA · (Female)

NPI # 1710181011
Status Active
Credentials
Entity Individual
Enumeration date 06/12/2007
Last updated 03/19/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # 1296
  • TX Medicaid 018809601
  • TX Other 0036QP BLUE CROSS
  • TX Other 480019673 MEDICARE RRB
  • TX Other 018809601 SUPERIOR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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