Provider Demographics
NPI:1427242643
Name:JAMES D OGDEN DPM & TERESA BARRIOS-OGDEN, DPM, PA
Entity type:Organization
Organization Name:JAMES D OGDEN DPM & TERESA BARRIOS-OGDEN, DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-921-0167
Mailing Address - Street 1:12042 BLANCO RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5440
Mailing Address - Country:US
Mailing Address - Phone:210-341-4183
Mailing Address - Fax:210-341-3831
Practice Address - Street 1:12042 BLANCO RD
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5440
Practice Address - Country:US
Practice Address - Phone:210-341-4183
Practice Address - Fax:210-341-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0910P213E00000X
TX0925P213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083157001Medicaid
TX00J36AMedicare PIN
TX083157001Medicaid