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Organization
SOUTHEAST SOUTH TEXAS CENTER FOR PEDIATRIC CARE
Active
Organization
SOUTHEAST SOUTH TEXAS CENTER FOR PEDIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M DALUZ (CREDENTIALING MANAGER)
(210) 576-0533
Entity
Organization
Contact information
Practice address
4212 E SOUTHCROSS BLVD, SUITE 150, SAN ANTONIO, TX 78222-3735
(210) 576-0533
(210) 226-4676
Mailing address
1954 E HOUSTON ST, SUITE 104, SAN ANTONIO, TX 78202-2951
(210) 576-0533
(210) 226-4676
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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