Provider Demographics
NPI:1598983280
Name:PEDIATRIC CLINIC OF SOUTH TEXAS
Entity Type:Organization
Organization Name:PEDIATRIC CLINIC OF SOUTH TEXAS
Other - Org Name:FE E PIZARRO, M.D. P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PIZARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-776-9374
Mailing Address - Street 1:9702 S PADRE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-5130
Mailing Address - Country:US
Mailing Address - Phone:361-937-5311
Mailing Address - Fax:361-937-5576
Practice Address - Street 1:9702 S PADRE ISLAND DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5130
Practice Address - Country:US
Practice Address - Phone:361-937-5311
Practice Address - Fax:361-937-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG63672080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB91292Medicare UPIN