Provider Demographics
NPI:1144350380
Name:CLINICA DEL NORTE PEDIATRICS PLLC
Entity type:Organization
Organization Name:CLINICA DEL NORTE PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-572-1430
Mailing Address - Street 1:102 BABCOCK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-3806
Mailing Address - Country:US
Mailing Address - Phone:210-572-1430
Mailing Address - Fax:210-572-1434
Practice Address - Street 1:102 BABCOCK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3806
Practice Address - Country:US
Practice Address - Phone:210-572-1430
Practice Address - Fax:210-572-1434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty