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PEDIATRIC SPECIALTY RURAL HEALTH CLINICLTD NPI 1851486500


NPI Information

NPI: 1851486500
Provider Name: PEDIATRIC SPECIALTY RURAL HEALTH CLINIC,LTD

Doing Business As: D/B/A EAGLE PASS PEDIATRIC HEALTH CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
710 WILLIAMS ST
EAGLE PASS, TX
ZIP 78852
Phone: (830) 773-1103
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PEDIATRIC SPECIALTY RURAL HEALTH CLINIC,LTD is a clinic center in Eagle Pass, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PEDIATRIC SPECIALTY RURAL HEALTH CLINIC,LTD NPI is 1851486500. The provider is registered as an organization entity type.
The provider Is Doing Business As D/b/a Eagle Pass Pediatric 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 10/4/2006 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
1261Q00000XClinic/CenterF3442TEXASYes

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
1130941102OTHERTEXASDR.RICARDO DE LOS SANTOS
2453935MEDICARE ID-TYPE UNSPECIFIEDTEXASPEDIATRICSPECIALTYRURALHE
3C15128MEDICARE UPINTEXAS
48127J1OTHERTEXASBLUECROSSBLUESHIELD
5742708192OTHERTEXASTAX ID
6453819MEDICARE ID-TYPE UNSPECIFIEDTEXASD/B/AEAGLEPASSPEDIATRICHE
7111923202MEDICARE ID-TYPE UNSPECIFIEDTEXASRURAL CLINIC
800251NMEDICARE ID-TYPE UNSPECIFIEDTEXASMEDICARE

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

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