Provider Demographics
NPI:1386725257
Name:WELDY, BRENDA JOY (DPM)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:JOY
Last Name:WELDY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 SERENITY DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8144
Mailing Address - Country:US
Mailing Address - Phone:512-589-1132
Mailing Address - Fax:512-251-3370
Practice Address - Street 1:1902 SERENITY DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-8144
Practice Address - Country:US
Practice Address - Phone:512-589-1132
Practice Address - Fax:512-251-3370
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2011-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4667213E00000X
TX1797213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J7624OtherHOME FOOT CARE
TX8J7623OtherAAMPS
TXP00417476OtherRAILROAD MEDICARE NUMBER
TX8J7624OtherHOME FOOT CARE