Provider Demographics
NPI:1144650060
Name:SAN ANTONIO CHILDRENS SURGICAL
Entity type:Organization
Organization Name:SAN ANTONIO CHILDRENS SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-489-2198
Mailing Address - Street 1:8706 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1200
Mailing Address - Country:US
Mailing Address - Phone:713-481-9500
Mailing Address - Fax:
Practice Address - Street 1:8706 FREDERICKSBURG RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1293
Practice Address - Country:US
Practice Address - Phone:210-598-7918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH END HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-13
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical