PEDIATRIC SPECIALTY RURAL HEALTH CLINIC LTD. NPI 1104958081

NPI Information

NPI: 1104958081
Provider Name: PEDIATRIC SPECIALTY RURAL HEALTH CLINIC, LTD.
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
710 WILLIAMS ST
EAGLE PASS, TX
ZIP 78852
Phone: (830) 773-1103
Get Directions

PEDIATRIC SPECIALTY RURAL HEALTH CLINIC, LTD. is a rural health clinic center in Eagle Pass, TX. PEDIATRIC SPECIALTY RURAL HEALTH CLINIC, LTD. NPI is 1104958081. The provider is registered as an organization entity type and is a single specialty group.

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 3/9/2007 and was last updated on 4/6/2023.

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			No
3	261QR1300X	Clinic/Center	Rural Health	F3442	TEXAS	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	121077504	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

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.

« Previous NPI

Next NPI »