Organization
PEDIATRIC INTENSIVE CARE OF SAN ANTONIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL SEDILLO M.D. (PRESIDENT)
(210) 558-6288
Entity
Organization
Contact information
Practice address
520 MADISON OAK, SAN ANTONIO, TX 78258-3913
(210) 558-6288
(210) 558-6289
Mailing address
PO BOX 2406, SAN ANTONIO, TX 78298-2406
(210) 558-6288
(210) 558-6289
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189099801
—
TX
Enumeration date
11/15/2007
Last updated
08/13/2011
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