Organization
SAN ANGELO PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WALDO HERBERT M. D. (OWNER)
(325) 653-6944
Entity
Organization
Contact information
Practice address
314 E TWOHIG AVE, SAN ANGELO, TX 76903-5502
(325) 653-6944
(325) 658-6500
Mailing address
314 E TWOHIG AVE, SAN ANGELO, TX 76903-5502
(325) 653-6944
(325) 658-6500
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D9492
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00JT67
BLUE CROSS ID
TX
Enumeration date
10/17/2006
Last updated
08/22/2020
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