Individual
DR. PRESTON JOHN PANICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
14615 SAN PEDRO AVE STE 160, SAN ANTONIO, TX 78232-4364
(210) 899-1026
(210) 490-1878
Mailing address
8122 DATAPOINT DR STE 720, SAN ANTONIO, TX 78229-3479
(210) 889-1026
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2045
NV
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
3057
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
59.000613
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11467803064
—
NV
Enumeration date
06/24/2016
Last updated
05/12/2026
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