1417954421 NPI number — DR. DANIEL L. BELL DPM, PA

Table of content: DR. DANIEL L. BELL DPM, PA (NPI 1417954421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417954421 NPI number — DR. DANIEL L. BELL DPM, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELL
Provider First Name:
DANIEL
Provider Middle Name:
L.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM, PA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOOT CENTER
Provider Other First Name:
LAREDO
Provider Other Middle Name:
FAMILY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPM, PA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1417954421
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/20/2006
NPI Reactivation Date:
05/02/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
604 SHILOH DR STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAREDO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78045-6766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-753-3668
Provider Business Mailing Address Fax Number:
956-753-3672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
604 SHILOH DR
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78045-6765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-753-3668
Provider Business Practice Location Address Fax Number:
956-753-3672
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  1222 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 480030209 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4418530001 . This is a "DMERC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 157039201 . This is a "MEDICAID DME" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 089812401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 157039202 . This is a "MEDICAID HOME HEALTH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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