Organization
GUILLERMO URUETA PEDIATRICS PA
Active
Other names
KidsCorner Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUILLERMO AUGUSTO URUETA M.D. (OWNER)
(830) 773-7662
Entity
Organization
Contact information
Practice address
2198 E GARRISON ST, EAGLE PASS, TX 78852-5076
(830) 773-7662
(830) 773-7664
Mailing address
2198 E GARRISON ST, EAGLE PASS, TX 78852-5076
(830) 773-7662
(830) 773-7664
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179181601
—
TX
01
—
E01008299
DPS NUMBER
—
01
—
K6379
STAE MEDICAL LICENSE
TX
Enumeration date
03/28/2007
Last updated
01/15/2025
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