Organization
AIRLINE PEDIATRICS, P.A.
Active
Other names
Suresh N. Pathikonda, M.D, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH N PATHIKONDA M.D, (OWNER)
(361) 575-8500
Entity
Organization
Contact information
Practice address
601 E AIRLINE RD, VICTORIA, TX 77901-3926
(361) 575-8500
(361) 575-8416
Mailing address
601 E AIRLINE RD, VICTORIA, TX 77901-3926
(361) 575-8500
(361) 575-8416
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039AZ
BCBS GROUP
TX
05
—
079684901
—
TX
05
—
079684902
—
TX
Enumeration date
03/07/2007
Last updated
06/06/2013
Update your record
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