| Yeled Shalom Pediatric Clinic | |
|
1975 N Veterans Blvd Ste. 5 Eagle Pass TX 78852-4456 | |
| (830) 773-9449 | |
| (830) 757-3142 |
| Full Name | Yeled Shalom Pediatric Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1975 N Veterans Blvd, Eagle Pass, Texas |
| Authorized Official Name and Position | Eliezer Hernandez (OWNER) |
| Authorized Official Contact | 8307739449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yeled Shalom Pediatric Clinic Po Box 1145 Eagle Pass TX 78853-1145 Ph: (830) 773-9449 | Yeled Shalom Pediatric Clinic 1975 N Veterans Blvd Ste. 5 Eagle Pass TX 78852-4456 Ph: (830) 773-9449 |
| NPI Number | 1770540684 |
|---|---|
| Provider Enumeration Date | 04/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6406983188 |
|---|---|
| Medicare Enrollment ID | O20100429000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770540684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | J6834 (Texas) | Primary |
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