Provider Demographics
NPI:1821538034
Name:ALL STAR PEDIATRICS
Entity Type:Organization
Organization Name:ALL STAR PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GO-MALIWANAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-452-7704
Mailing Address - Street 1:5920 SARATOGA BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4120
Mailing Address - Country:US
Mailing Address - Phone:361-452-7704
Mailing Address - Fax:361-452-7709
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-452-7704
Practice Address - Fax:361-452-7709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9542208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty