Organization
SOUTH PADRE ISLAND PEDIATRIC CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA POWELL (PRACTICE ADMINISTRATOR)
(361) 854-4626
Entity
Organization
Contact information
Practice address
1210 GREGORY ST STE 2, TAFT, TX 78390-3045
(361) 528-2595
Mailing address
3845 S PADRE ISLAND DR, CORPUS CHRISTI, TX 78415-2919
(361) 854-4626
(361) 851-5193
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2025
Last updated
01/20/2026
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