Organization
BRAZOS VALLEY FOOT CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA LOUISE GARZA (BILLING MANAGER)
(979) 776-6060
Entity
Organization
Contact information
Practice address
3312 LONGMIRE DR, COLLEGE STATION, TX 77845-5812
(979) 776-6060
(979) 776-6172
Mailing address
3312 LONGMIRE DR, COLLEGE STATION, TX 77845-5812
(979) 776-6060
(979) 776-6172
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00613K
BLUECROSSBLUESHIELD
TX
05
—
080873501
—
TX
Enumeration date
08/19/2006
Last updated
01/17/2019
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