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Blazing Indigo Llc
Foot & Ankle Surgery Podiatrist in San Juan, Texas
NPI 1306161567

Blazing Indigo Llc is a Foot & Ankle Surgery Podiatrist based in San Juan, TX and is specialized in Foot & Ankle Surgery. Blazing Indigo Llc practices in San Juan, TX. The NPI Number for Blazing Indigo Llc is 1306161567 and holds a License No. 1412 (Texas).

The current practice location address for Blazing Indigo Llc is 409 W Fm 495, San Juan, TX and can be reached out via phone at 956-782-6200 and via fax at 956-782-6202.

Location: 409 W Fm 495, San Juan, TX, 78589-3717
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306161567
Provider Name
Blazing Indigo Llc
Credential
Provider Entity Type
Organization
Address
409 W Fm 495, San Juan, TX, 78589-3717
Phone Number
956-782-6200
Fax Number
956-782-6202
Provider Enumeration Date
03/31/2010
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
409 W Fm 495
City
San Juan
State
Texas
Zip
78589-3717
Phone Number
956-782-6200
Fax Number
956-782-6202
person
Provider Business Mailing Address Details
Address
409 W Fm 495
City
San Juan
State
Texas
Zip
78589-3717
Phone Number
956-782-6200
Fax Number
956-782-6202
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
1412 (Texas)
Definition
Definition to come...
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