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Organization
SOUTHEAST TEXAS PEDIATRIC CENTER PA
Active
Organization
SOUTHEAST TEXAS PEDIATRIC CENTER PA
Active
Other names
SOUTHEAST TEXAS PEDIATRIC CENTER PA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERTO MAYOR (ADMINISTRATOR)
(409) 729-9200
Entity
Organization
Contact information
Practice address
2400 HIGHWAY 365 STE 107, NEDERLAND, TX 77627-6268
(409) 729-9200
(409) 729-9235
Mailing address
2400 HIGHWAY 365 STE 107, NEDERLAND, TX 77627-6268
(409) 729-9200
(409) 729-9235
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
08/11/2023
Last updated
09/14/2023
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