Organization
VICTORIA PEDIATRICS & ADOLESCENTS ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX F REGUEIRA (PRESIDENT)
(361) 576-2134
Entity
Organization
Contact information
Practice address
4304 RETAMA CIR, VICTORIA, TX 77901-2767
(361) 576-2134
(361) 578-0221
Mailing address
4304 RETAMA CIR, VICTORIA, TX 77901-2767
(361) 576-2134
(361) 578-0221
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E9354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059DJ
BLUE CROSS BLUE SHIELD
TX
05
—
060378901
—
TX
05
—
092298101
—
TX
05
—
092298102
—
TX
01
—
4331614
AETNA
TX
01
—
82920X
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/05/2006
Last updated
06/24/2008
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