Organization
PEDIATRIC SURGICAL SPECIALISTS OF SOUTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MARK MORALES M.D. (PRESIDENT)
(361) 854-0201
Entity
Organization
Contact information
Practice address
3533 S ALAMEDA ST, #209, CORPUS CHRISTI, TX 78411-1721
(361) 854-0201
(361) 855-7572
Mailing address
PO BOX 30104, CORPUS CHRISTI, TX 78463-0104
(361) 854-0201
(361) 855-7572
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
J5418
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
L1528
TX
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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