Organization
SOUTH PADRE ISLAND PEDIATRIC CLINIC PA
Active
Organization
SOUTH PADRE ISLAND PEDIATRIC CLINIC PA
Active
Other names
South Padre Island Pediatric Clinic, SOUTH PADRE ISLAND PEDIATRIC CNTR-ARANSAS PASS
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA POWELL (PRACTICE ADMINISTRATOR)
(512) 789-3844
Entity
Organization
Contact information
Practice address
160 S. 13TH STREET, ARANSAS PASS, TX 78336
(361) 758-1984
(361) 851-5193
Mailing address
160 S 13TH ST, ARANSAS PASS, TX 78336-4434
(361) 758-1984
(361) 851-5193
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
E4618
TX
261QR1300X
Rural Health Clinic/Center
G6791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127051406
—
TX
Enumeration date
11/24/2008
Last updated
10/29/2025
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