Healthcare Provider Details
I. General information
NPI: 1962212159
Provider Name (Legal Business Name): TORTUGA PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5920 SARATOGA BLVD STE 340
CORPUS CHRISTI TX
78414-4119
US
IV. Provider business mailing address
4101 S ALAMEDA ST
CORPUS CHRISTI TX
78411-1528
US
V. Phone/Fax
- Phone: 541-212-3866
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BETHANY
VARGAS
Title or Position: PEDIATRICIAN/OWNER
Credential: DO
Phone: 541-212-3866