Organization
PODIATRY CLINICS P,A,
Active
Other names
Podiatry Clinics P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHERINE M REZENDES D.P.M. (PRESIDENT/OWNER)
(210) 655-9965
Entity
Organization
Contact information
Practice address
12413 JUDSON RD, STE 120, LIVE OAK, TX 78233-3202
(210) 655-9965
(210) 655-9985
Mailing address
12413 JUDSON RD, STE 120, LIVE OAK, TX 78233-3202
(210) 655-9965
(210) 655-9985
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031HQ
BCBS
—
05
—
178288001
—
TX
Enumeration date
10/30/2007
Last updated
11/24/2009
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