Christus Pediatric Physician Group
Pediatrics in San Antonio, TX. Organization (NPI-2).
NPI number1346652575
StatusActive
Last updated in NPPESJan 27, 2022
Details
- NPI
- 1346652575
- Entity type
- Organization (NPI-2)
- Legal business name
- Christus Pediatric Physician Group
- Organization subpart
- No
- Enumeration date
- May 22, 2014
- Certification date
- Jan 27, 2022
- Last updated
- Jan 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 207VX0000X | Obstetrics & Gynecology, Obstetrics | – | – |
Other names
- Children'S Hospital Of San Antonio Physician Group (Doing Business As)
Practice location
100 Ne Loop 410Suite 800
San Antonio, TX 78216
Phone 210-704-8706 · Fax 210-704-4695
Mailing address
100 Ne Loop 410Suite 800
San Antonio, TX 78216-4700
Phone 210-704-8706 · Fax 210-704-4695
Authorized official
Clinton Kotal
Executive Director
2107048706
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