Healthcare Provider Details

I. General information

NPI: 1801856786
Provider Name (Legal Business Name): CHILDREN'S PHYSICIAN SERVICES OF SOUTH TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1721
US

IV. Provider business mailing address

4525 AYERS ST
CORPUS CHRISTI TX
78415-1401
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-5000
  • Fax:
Mailing address:
  • Phone: 361-694-1684
  • Fax: 361-808-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH ANNE GARZA
Title or Position: VP
Credential:
Phone: 361-694-5081