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Organization
SHORELINE PODIATRY, PA
Active
Organization
SHORELINE PODIATRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD B KILLIAN DPM (PODIATRIST OWNER)
(361) 334-1136
Entity
Organization
Contact information
Practice address
613 ELIZABETH ST, STE 513, CORPUS CHRISTI, TX 78404-2220
(361) 881-8313
(361) 881-8323
Mailing address
PO BOX 271416, CORPUS CHRISTI, TX 78427-1416
(361) 334-1136
(361) 334-1574
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
1537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048MQ
BCBS OF TX
TX
05
—
174333801
—
TX
05
—
174333802
—
TX
05
—
174333803
—
TX
01
—
5451980001
MEDICARE NSC
TX
01
—
610351300
DEPARTMENT OF LABOR
TX
01
—
DD0599
RAILROAD MEDICARE
TX
Enumeration date
07/01/2006
Last updated
07/11/2008
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