Organization
HEALTHDRIVE PODIATRY GROUP, PA
Active
Other names
Mary C. Manesis, DPM, PA, HealthDrive Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE L. TRBOVICH DPM (OWNER/PRACTICE DIRECTOR)
(857) 255-0486
Entity
Organization
Contact information
Practice address
2413 EAST LOOP 820 NORTH, FORT WORTH, TX 76118-8210
(888) 964-6681
(888) 662-0859
Mailing address
100 CROSSING BLVD, SUITE 300, FRAMINGHAM, MA 01702-5555
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201090202
—
TX
01
—
DD6485
MEDICARE RAILROAD
TX
Enumeration date
11/19/2008
Last updated
01/02/2020
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