Organization
CHILD STUDY CLINIC
Active
Other names
South Texas Assessment & Referral Services
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE SERRANO (CLINIC COORDINATOR I)
(361) 575-0681
Entity
Organization
Contact information
Practice address
117 MEDICAL DR STE 4, VICTORIA, TX 77904-3114
(361) 575-0681
(361) 575-0100
Mailing address
117 MEDICAL DR STE 4, VICTORIA, TX 77904-3114
(361) 575-0681
(361) 575-0100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G6459
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119071202
—
TX
Enumeration date
08/21/2008
Last updated
02/05/2009
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