Organization
AUSTIN PODIATRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSIE NELY SANTANNA DPM (OWNER)
(512) 719-4545
Entity
Organization
Contact information
Practice address
4100 DUVAL RD STE 2-102, AUSTIN, TX 78759-4273
(512) 719-4545
(512) 719-5511
Mailing address
4100 DUVAL RD 2-102, AUSTIN, TX 78759
(512) 719-4545
(512) 719-5511
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM1258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000010CK
BLUE CROSS NUMBER
TX
Enumeration date
05/10/2007
Last updated
07/21/2008
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