Organization
VICTORIA SURGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW CLEMMONS D.O. (SENIOR PARTNER)
(361) 575-6396
Entity
Organization
Contact information
Practice address
601 E SAN ANTONIO ST, SUITE 501, VICTORIA, TX 77901-6052
(361) 575-6396
(361) 575-2728
Mailing address
601 E SAN ANTONIO ST, SUITE 501, VICTORIA, TX 77901-6052
(361) 575-6396
(361) 575-2728
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004168
KIDNEY HEALTHCARE
TX
01
—
00L365
BLUECROSS BLUESHIELD
TX
05
—
083720501
—
TX
01
—
CP2130
RAILROAD MEDICARE
TX
Enumeration date
05/09/2006
Last updated
08/10/2016
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