Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1357 | TX |
N | 222Z00000X | Podiatrist | 1357 | TX |
Y | 213EP1101X | Primary Podiatric Medicine | 1357 | TX |
N | 213ES0103X | Foot & Ankle Surgery | 1357 | TX |
NPI | 1568464634 |
---|---|
Provider Name | Dr. Maureen Leigh Caldwell |
First Address | Victoria, TX 77901-3948 |
Second Address | Victoria, TX 77901-3948 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 01/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
092736002 | (05) | TX |
84530N | BCBS PROVIDER NUMBER (01) | TX |
P00143475 | RAILROAD MEDICARE (01) | TX |
U71143 | (02) | TX |