Provider Demographics
NPI:1700072964
Name:NEONATOLOGY CONSULTNANTS OF SOUTH TEXAS PLLC
Entity Type:Organization
Organization Name:NEONATOLOGY CONSULTNANTS OF SOUTH TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-653-6361
Mailing Address - Street 1:PO BOX 6160
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6160
Mailing Address - Country:US
Mailing Address - Phone:361-653-6361
Mailing Address - Fax:361-653-6371
Practice Address - Street 1:3111 CENTER POINT DR
Practice Address - Street 2:#A
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8545
Practice Address - Country:US
Practice Address - Phone:956-631-1039
Practice Address - Fax:956-631-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188870301Medicaid