Individual
DR. ALLAN SEBASTIAN GANESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
6200 REGIONAL PLZ, SUITE# 1450, ABILENE, TX 79606-5250
(325) 480-1177
Mailing address
834 SWIFT WATER DR, ABILENE, TX 79602-8170
(267) 259-1786
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1862
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3274
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195625201
—
TX
01
—
8AW296
BLUE CROSS BLUE SHIELD PROVIDER #
TX
01
—
P00677666
RAIL ROAD MEDICARE GROUP MEMBER PTAN
TX
Enumeration date
04/23/2008
Last updated
09/11/2009
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