SHORELINE PODIATRY PA NPI 1538198767

NPI Information

SHORELINE PODIATRY, PA is a podiatrist in Corpus Christi, TX. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. SHORELINE PODIATRY, PA NPI is 1538198767. The provider is registered as an organization entity type.

The provider's business location address is:

613 ELIZABETH ST
STE 513
CORPUS CHRISTI, TX
ZIP 78404-220
Phone: (361) 881-8313
Fax: (361) 881-8323

The provider's authorized official is Ronald B Killian .
The authorized official title is Podiatrist Owner and has the following contact phone number (361) 334-1136.

The CLIA number assigned to this NPI record is 45D0664371 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 7/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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