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Organization
HEALTHDRIVE PODIATRY GROUP, PA
Active
Organization
HEALTHDRIVE PODIATRY GROUP, PA
Active
Other names
Mary C. Manesis, DPM, PA, HealthDrive Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE L. TRBOVICH DPM (OWNER/PRACTICE DIRECTOR)
(857) 255-0486
Entity
Organization
Contact information
Practice address
2413 EAST LOOP 820 NORTH, FORT WORTH, TX 76118-8210
(888) 964-6681
(888) 662-0859
Mailing address
100 CROSSING BLVD, SUITE 300, FRAMINGHAM, MA 01702-5555
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201090202
—
TX
01
—
DD6485
MEDICARE RAILROAD
TX
Enumeration date
11/19/2008
Last updated
01/02/2020
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