Individual
DR. MICHAEL E ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1901 BABCOCK RD STE 102, SAN ANTONIO, TX 78229-4544
(210) 872-3668
(210) 428-6317
Mailing address
94 BRIGGS ST STE 600, SAN ANTONIO, TX 78224-1272
(210) 872-3668
(210) 428-6317
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121586504
—
TX
01
—
480034724
MEDICARE RAILROAD
—
01
—
83000G
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/04/2006
Last updated
11/01/2022
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