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Organization
SAN ANGELO PEDIATRIC ASSOCIATES, P.A.
Active
Organization
SAN ANGELO PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WALDO HERBERT M. D. (OWNER)
(325) 653-6944
Entity
Organization
Contact information
Practice address
314 E TWOHIG AVE, SAN ANGELO, TX 76903-5502
(325) 653-6944
(325) 658-6500
Mailing address
314 E TWOHIG AVE, SAN ANGELO, TX 76903-5502
(325) 653-6944
(325) 658-6500
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D9492
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00JT67
BLUE CROSS ID
TX
Enumeration date
10/17/2006
Last updated
08/22/2020
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