Organization
PEDIATRIC SPECIALTY RURAL HEALTH CLINIC, LTD.
Active
Other names
Eagle Pass Pediatric Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA W DE LOS SANTOS BBA (CEO)
(830) 773-1103
Entity
Organization
Contact information
Practice address
710 WILLIAMS ST, EAGLE PASS, TX 78852-5126
(830) 773-1103
(830) 757-8366
Mailing address
710 WILLIAMS ST, EAGLE PASS, TX 78852-5126
(830) 773-1103
(830) 757-8366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
F3442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121077504
—
TX
Enumeration date
03/09/2007
Last updated
10/07/2025
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