| Organization Name: | SOUTH PADRE ISLAND PEDIATRIC CENTER |
| NPI Number: | 1720233687 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDY GONZALEZ (OFFICE MANAGER) |
| Mailing Address: | 301 S San Patricio St Sinton |
| State: | TX US |
| Postal Code: | 783872432 |
| Phone Number: | 3613643355 |
| Fax Number: | 3618515193 |
| NPI Enumeration Date: | 11/19/2008 |
| NPI Last Update Date: | 11/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | G6791 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |