Provider Demographics
NPI:1588758791
Name:KONKOL, JOHN E JR (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:KONKOL
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:5825 CALLAGHAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1106
Mailing Address - Country:US
Mailing Address - Phone:210-227-8700
Mailing Address - Fax:210-348-9130
Practice Address - Street 1:215 E QUINCY ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2039
Practice Address - Country:US
Practice Address - Phone:210-299-3922
Practice Address - Fax:210-299-1958
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-02-12
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Provider Licenses
StateLicense IDTaxonomies
IL016-005253213ES0103X
TX1874213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198497301Medicaid
TX1972604064Medicare NSC
TX8L3840Medicare PIN