Organization
CENTER FOR FOOT AND ANKLE SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES JASON HUBBARD D.P.M. (OWNER)
(512) 477-8853
Entity
Organization
Contact information
Practice address
1015 E 32ND ST, STE 204, AUSTIN, TX 78705-2707
(512) 477-8853
(512) 477-2592
Mailing address
P.O. BOX 4948, AUSTIN, TX 78765-4948
(512) 477-8853
(512) 477-2592
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
1625
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093JQ
BCBS OF TEXAS
TX
05
—
158149801
—
TX
Enumeration date
03/16/2006
Last updated
05/07/2014
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