Pediatric Specialty Rural Health Clinic
NPI #1730204264 in Eagle Pass, Texas
Provider Information
- NPI Number
- 1730204264
- Entity Type
- Organization
- Organization Name
- Pediatric Specialty Rural Health Clinic
- Primary Specialty
- Specialist
- Enumeration Date
- Mar 21, 2007
- Last Updated
- Nov 3, 2010
Practice Location
- Address
- 710 WILLIAMS ST
- City
- Eagle Pass
- State
- Texas
- ZIP Code
- 78852-5126
- Phone
- (830) 773-1103
Authorized Official
- Name
- MRS. DEBRA W DE LOS SANTOS
- Title
- CEO
- Phone
- (830) 773-1103
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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