Organization
GULF COAST FOOT CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEINBERG DPM (PRESIDENT)
(361) 576-3060
Entity
Organization
Contact information
Practice address
815 N VIRGINIA ST, PORT LAVACA, TX 77979-3025
(361) 552-0295
Mailing address
PO BOX 125, PORT LAVACA, TX 77979-0125
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
1296
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018809601
SUPERIOR
TX
05
—
018809601
—
TX
01
—
480019673
MEDICARE RRB
TX
01
—
8AJ751
BLUE CROSS
TX
Enumeration date
01/05/2007
Last updated
09/05/2008
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