Organization
SOUTH PADRE ISLAND PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MULUKUTLA RAMAKRISHNA M.D. (PRESIDENT)
(361) 854-4626
Entity
Organization
Contact information
Practice address
3845 S SPID DR, CORPUS CHRISTI, TX 78415-2919
(361) 854-4626
Mailing address
3845 S SPID DR, CORPUS CHRISTI, TX 78415-2919
(361) 854-4626
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E4618
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092694101
—
TX
05
—
093832601
—
TX
05
—
121157503
—
TX
05
—
127051403
—
TX
05
—
127051404
—
TX
05
—
127051405
—
TX
05
—
127051406
—
TX
05
—
127051407
—
TX
05
—
645660168
—
TX
05
—
645663163
—
TX
05
—
645665166
—
TX
05
—
645666168
—
TX
Enumeration date
07/30/2007
Last updated
07/30/2007
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