Organization
PEDIATRIC SPECIALTY RURAL HEALTH CLINIC,LTD
Active
Organization
PEDIATRIC SPECIALTY RURAL HEALTH CLINIC,LTD
Active
Other names
d/b/a Eagle Pass Pediatric Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA W DE LOS SANTOS (CEO)
(830) 773-1103
Entity
Organization
Contact information
Practice address
710 WILLIAMS ST, EAGLE PASS, TX 78852-5126
(830) 773-1103
(830) 757-8366
Mailing address
PO BOX 2368, EAGLE PASS, TX 78853-2368
(830) 773-1103
(830) 757-8366
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
F3442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130941102
DR.RICARDO DE LOS SANTOS
TX
01
—
742708192
TAX ID
TX
01
—
8127J1
BLUECROSSBLUESHIELD
TX
Enumeration date
10/04/2006
Last updated
11/03/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up