| South Padre Island Pediatric Center | |
|
220 E. St. Mary's Street Mathis TX 78368 | |
| (361) 758-1984 | |
| (361) 851-5193 |
| Full Name | South Padre Island Pediatric Center |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 220 E. St. Mary's Street, Mathis, Texas |
| Authorized Official Name and Position | Sandy Gonzalez (OFFICE MANAGER) |
| Authorized Official Contact | 3618544626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Padre Island Pediatric Center 220 E. St. Mary's Street Mathis TX 78368 Ph: (361) 547-5100 | South Padre Island Pediatric Center 220 E. St. Mary's Street Mathis TX 78368 Ph: (361) 758-1984 |
| NPI Number | 1134374713 |
|---|---|
| Provider Enumeration Date | 11/24/2008 |
| Last Update Date | 11/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134374713 | NPI | - | NPPES |
| 127051405 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | G6791 (Texas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | E4618 (Texas) | Primary |
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