Organization
CHRISTUS PEDIATRIC PHYSICIAN GROUP
Active
Other names
Children's Hospital of San Antonio Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON KOTAL (EXECUTIVE DIRECTOR)
(210) 704-8706
Entity
Organization
Contact information
Practice address
100 NE LOOP 410, SUITE 800, SAN ANTONIO, TX 78216
(210) 704-8706
(210) 704-4695
Mailing address
100 NE LOOP 410, SUITE 800, SAN ANTONIO, TX 78216-4700
(210) 704-8706
(210) 704-4695
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/22/2014
Last updated
01/27/2022
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