CHILDRENS CLINIC OF DIMMIT AND ZAVALA PA NPI 1972664613

NPI Information

NPI: 1972664613
Provider Name: CHILDRENS CLINIC OF DIMMIT AND ZAVALA PA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 45D0956840

Address:
403 S 7TH ST
CARRIZO SPRINGS, TX
ZIP 78834
Phone: (830) 876-9870
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CHILDRENS CLINIC OF DIMMIT AND ZAVALA PA is a rural health clinic center in Carrizo Springs, TX. CHILDRENS CLINIC OF DIMMIT AND ZAVALA PA NPI is 1972664613. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

403 S 7TH ST
CARRIZO SPRINGS, TX
ZIP 78834-805
Phone: (830) 876-9870
Fax: (830) 876-3661

The provider's authorized official is Abelardo Sabangan Doria .
The authorized official title is President and has the following contact phone number (830) 876-9870.

The CLIA number assigned to this NPI record is 45D0956840 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 1/23/2019.

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
1	208000000X	Pediatrics				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

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
1	111931502	OTHER		THSTERS
2	1577750401	MEDICAID	TEXAS

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

NPI Synchronization or Removal

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