Provider Demographics
NPI:1316494628
Name:STRIDE ANEW, PLLC
Entity type:Organization
Organization Name:STRIDE ANEW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:850-420-3703
Mailing Address - Street 1:10730 POTRANCO RD
Mailing Address - Street 2:SUITE 122-240
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3327
Mailing Address - Country:US
Mailing Address - Phone:210-570-6523
Mailing Address - Fax:
Practice Address - Street 1:13923 EVELINA
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4416
Practice Address - Country:US
Practice Address - Phone:210-570-6523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2162213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty