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Organization
SOUTH TEXAS MEDICAL CLINICS, P.A.
Active
Organization
SOUTH TEXAS MEDICAL CLINICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. RICHARD (EXECUTIVE DIRECTOR)
(979) 532-6701
Entity
Organization
Contact information
Practice address
2100 REGIONAL MEDICAL DR, WHARTON, TX 77488-9719
(979) 532-1700
(979) 532-4584
Mailing address
2100 REGIONAL MEDICAL DR, WHARTON, TX 77488-9719
(979) 532-1700
(979) 532-4584
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H2422
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00L423
BCBS OF TEXAS
TX
05
—
138702903
—
TX
01
—
CO9161
RAILROAD GBA - RAILROAD MEDICARE
TX
Enumeration date
09/13/2006
Last updated
06/14/2011
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