Provider Demographics
NPI:1497795793
Name:SOUTH TEXAS CHILDREN'S CLINIC
Entity Type:Organization
Organization Name:SOUTH TEXAS CHILDREN'S CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:956-787-8277
Mailing Address - Street 1:1044 W. ACACIA
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516
Mailing Address - Country:US
Mailing Address - Phone:956-787-8277
Mailing Address - Fax:956-787-2309
Practice Address - Street 1:1044 W. ACACIA
Practice Address - Street 2:SUITE B
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516
Practice Address - Country:US
Practice Address - Phone:956-787-8277
Practice Address - Fax:956-787-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty