Provider Demographics
NPI:1053780460
Name:FOOT & ANKLE SPECIALISTS OF CORPUS CHRISTI PLLC
Entity type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF CORPUS CHRISTI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOLSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:361-884-3984
Mailing Address - Street 1:3301 S ALAMEDA ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1882
Mailing Address - Country:US
Mailing Address - Phone:361-884-3984
Mailing Address - Fax:361-452-3262
Practice Address - Street 1:3301 S ALAMEDA ST
Practice Address - Street 2:SUITE #306
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1882
Practice Address - Country:US
Practice Address - Phone:361-884-3984
Practice Address - Fax:361-452-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric