DR. LARRY AJOLO BULAHAO DPM NPI 1962421180

NPI Information

NPI: 1962421180
Provider Name: DR. LARRY AJOLO BULAHAO, DPM
Classification: Podiatrist - 213EP1101X
Entity Type: Individual

Specialization: Primary Podiatric Medicine

PECOS Registration: Yes

Address:
2441 NACOGDOCHES RD
# 806
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 859-7718
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DR. Larry Ajolo Bulahao, DPM is a primary podiatric medicine podiatrist in San Antonio, TX. DR. Larry Ajolo Bulahao, DPM NPI is 1962421180. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2441 NACOGDOCHES RD
# 806
SAN ANTONIO, TX
ZIP 78217-044
Phone: (210) 859-7718

The NPI 1962421180 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 7/19/2006 and was last updated on 3/2/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	1606	TEXAS	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	157842901	MEDICAID	TEXAS
2	157844502	MEDICAID	TEXAS
3	4937640001	MEDICARE NSC
4	8J6639	MEDICARE PIN	TEXAS
5	P00216950	OTHER	TEXAS	RR MEDICARE
6	8A6036	MEDICARE PIN	TEXAS
7	P00450858	OTHER	TEXAS	RR MEDICARE
8	U94919	MEDICARE UPIN	TEXAS
9	8J6640	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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