Organization
GULF COAST FOOT CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD STEINBERG D.P.M. (PODIATRY)
(361) 552-0295
Entity
Organization
Contact information
Practice address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-0295
(361) 582-0615
Mailing address
PO BOX 125, PORT LAVACA, TX 77979-0125
(361) 552-0295
(866) 813-3644
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1296
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036QP
BLUE CROSS
TX
01
—
018809601
SUPERIOR
TX
05
—
018809601
—
TX
01
—
480019673
MEDICARE RRB
TX
Enumeration date
06/12/2007
Last updated
03/19/2012
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