Provider Demographics
NPI:1992327811
Name:ZIA FOOT & ANKLE
Entity type:Organization
Organization Name:ZIA FOOT & ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:915-422-3776
Mailing Address - Street 1:4208 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4151 CAMINO COYOTE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7096
Practice Address - Country:US
Practice Address - Phone:575-522-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHANIE GONZALEZ, DPM, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty