Provider Demographics
NPI:1730147380
Name:VEGLIA, RICHARD (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:VEGLIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 PLEASANTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1146
Mailing Address - Country:US
Mailing Address - Phone:210-924-0516
Mailing Address - Fax:210-924-0166
Practice Address - Street 1:1512 PLEASANTON RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1146
Practice Address - Country:US
Practice Address - Phone:210-924-0516
Practice Address - Fax:210-924-0166
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0734213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092838401Medicaid
TXT16405Medicare UPIN
TXTXB11856Medicare PIN