Provider Type Icon

PEDIATRIC SPECIALTY RURAL HEALTH CLINIC NPI 1730204264


NPI Information

NPI: 1730204264
Provider Name: PEDIATRIC SPECIALTY RURAL HEALTH CLINIC

Doing Business As: EAGLE PASS PEDIATIC HEALTH CLINIC

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
710 WILLIAMS ST
EAGLE PASS, TX
ZIP 78852
Phone: (830) 773-1103
Get Directions

PEDIATRIC SPECIALTY RURAL HEALTH CLINIC is a specialist in Eagle Pass, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PEDIATRIC SPECIALTY RURAL HEALTH CLINIC NPI is 1730204264. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eagle Pass Pediatic Health Clinic.

The provider's business location address is:

710 WILLIAMS ST
EAGLE PASS, TX
ZIP 78852-126
Phone: (830) 773-1103
Fax: (830) 757-8366

The provider's authorized official is Debra W De Los Santos .
The authorized official title is Ceo and has the following contact phone number (830) 773-1103.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 11/3/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistF3442TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C15128MEDICARE UPINTEXAS
21851486500OTHERTEXASDR RICARDO DE LOS SANTOS
31124150024OTHERTEXASDEBORAH A. THOMSON PAC
41841347838OTHERTEXASDR WENDY W. PITT
5018235401MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.