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Individual

COLLIN EUGENE PEHDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
701 S ZARZAMORA ST, SAN ANTONIO, TX 78207-5209
(210) 358-7717
(210) 358-7707
Mailing address
701 S ZARZAMORA ST, SAN ANTONIO, TX 78207-5209
(210) 358-7717
(210) 358-7707

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
2166
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
00782
IA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2166
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1912278490
WELLMARK BCBS
IA
05
1912278490
IA
05
352540401
TX
01
447448ZRNC
MEDICARE PTAN
TX
01
8FL880
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
P01045640
RR MEDICARE
IA
Enumeration date
08/18/2005
Last updated
05/20/2022
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