Individual
DR. MAUREEN LEIGH CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
116 IMPERIAL DR, STE A, VICTORIA, TX 77901-3948
(361) 578-2777
(361) 578-2778
Mailing address
116 IMPERIAL DR, STE A, VICTORIA, TX 77901-3948
(361) 578-2777
(361) 578-2778
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1357
TX
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
1357
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
1357
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092736002
—
TX
01
—
84530N
BCBS PROVIDER NUMBER
TX
01
—
P00143475
RAILROAD MEDICARE
TX
Enumeration date
06/02/2005
Last updated
09/01/2020
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