South Texas Foot & Ankle Specialist PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1856 Issued in TX

Legal business name

SOUTH TEXAS FOOT & ANKLE SPECIALIST PA

Practice address

6419 Polaris
Suite a 1
Laredo, TX 78041-4725

Phone

(956) 718-0075

Fax

(956) 718-0086

NPI assigned

Sep 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pablo Trevino, DPMNPI 1407041809

Title

Owner

Phone

(956) 718-0075

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pablo Trevino, DPM

  • Foot & Ankle Surgery Podiatrist
  • Laredo, TX
  • NPI 1407041809
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1144478694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 POLARIS",
            "address_2": "SUITE A 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780414725",
            "telephone_number": "956-718-0075",
            "fax_number": "956-718-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6419 POLARIS",
            "address_2": "SUITE A 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780414725",
            "telephone_number": "956-718-0075",
            "fax_number": "956-718-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS FOOT & ANKLE SPECIALIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "PABLO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-718-0075",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1407041809",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Texas Council on Alcohol and Drug Abuse
• South Texas Development Council
• South Texas Direct Kids LLC
• South Texas Direct Physical Therapy, LLC.
• South Texas Family Clinic of Laredo
• South Texas Health Centers, Inc
• South Texas Hearing
• South Texas Medical Equipment & Supplies
• South Texas Medx, LLC
• South Texas Optometrist PC

• Foot & Ankle Surgery Podiatrist in Laredo, TX
• Providers in Laredo, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.