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Organization

ST. PAUL CHILDREN'S MEDICAL CORPORATION

Active
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Organization

ST. PAUL CHILDREN'S MEDICAL CORPORATION

Active
Other names
Bethesda Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
CHELSEA COHEN (CHIEF OPERATIONS OFFICER)
(903) 531-9455
Entity
Organization

Contact information

Practice address
1350 E RICHARDS ST, TYLER, TX 75702-6153
(903) 531-9455
(903) 526-3118
Mailing address
1350 E RICHARDS ST, TYLER, TX 75702-6153
(903) 531-9455
(903) 526-3118

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
208000000X
Pediatrics Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203740001
—
TX
01
—
203740002
MEDICAID TH STEPS
TX
01
—
203740003
MEDICAID CSCHN
TX
Enumeration date
06/17/2009
Last updated
06/16/2025
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