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Organization
SOUTHWEST PODIATRY, LLP
Active
Organization
SOUTHWEST PODIATRY, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD R. BLUM DPM (MANAGING PARTNER, SOUTHWEST PODIATR)
(972) 566-3808
Entity
Organization
Contact information
Practice address
18208 PRESTON RD, SUITE D-9 LB 112, DALLAS, TX 75252-6007
(972) 566-3808
(972) 566-4690
Mailing address
18208 PRESTON RD, SUITE D-9 LB 112, DALLAS, TX 75252-6007
(972) 566-3808
(972) 566-4690
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036DX
BCBS GROUP NUMBER
TX
05
—
080802401
—
TX
01
—
CH3133
MEDICARE RAILROAD
TX
Enumeration date
06/25/2006
Last updated
07/12/2010
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