Pediatric Specialty Rural Health Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

License

F3442 Issued in TX

Legal business name

PEDIATRIC SPECIALTY RURAL HEALTH CLINIC

Doing business as

Eagle Pass Pediatic Health Clinic

Practice address

710 Williams St
Eagle Pass, TX 78852-5126

Phone

(830) 773-1103

Fax

(830) 757-8366

NPI assigned

Mar 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Debra W De Los Santos

Title

Ceo

Phone

(830) 773-1103

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Eagle Pass Pediatic Health Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ricardo De Los Santos, M.D.

  • Pediatrics Physician
  • Eagle Pass, TX
  • NPI 1790990802
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1730204264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2368",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788532368",
            "telephone_number": "830-773-1103",
            "fax_number": "830-757-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 WILLIAMS ST",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525126",
            "telephone_number": "830-773-1103",
            "fax_number": "830-757-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPECIALTY RURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "DE LOS SANTOS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "830-773-1103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F3442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018235401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEBORAH A. THOMSON PAC",
            "identifier": "1124150024",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR WENDY W. PITT",
            "identifier": "1841347838",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR RICARDO DE LOS SANTOS",
            "identifier": "1851486500",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Pass Pediatic Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessele R Ortiz, M.A. CCC-SLP, CBIS
• Sebastian Padron, MD
• Brenda J Paris, MD
• Patient Solutions LLC
• Peakform Chiropractic & Rehab LLC
• Pediatric Specialty Rural Health Clinic, LTD. (Eagle Pass Pediatric Health Clinic)
• Pediatric Specialty Rural Health Clinic,LTD (d/b/a Eagle Pass Pediatric Health Clinic)
• Luis Enrique Perales
• Rosa I Perez, F.N.P.
• Victor Manuel Perez

• Specialist in Eagle Pass, TX
• Providers in Eagle Pass, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.