Healthcare Provider Details

I. General information

NPI: 1548217433
Provider Name (Legal Business Name): SOUTH TEXAS RETINA CONSULTANTS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 SARATOGA BLVD SUITE 200
CORPUS CHRISTI TX
78413-2953
US

IV. Provider business mailing address

5540 SARATOGA BLVD SUITE 200
CORPUS CHRISTI TX
78413-2953
US

V. Phone/Fax

Practice location:
  • Phone: 361-993-8510
  • Fax: 361-993-9184
Mailing address:
  • Phone: 361-993-8510
  • Fax: 361-993-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD5362
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberD5362
License Number StateTX

VIII. Authorized Official

Name: CHARLES H CAMPBELL
Title or Position: SENIOR PHYSICIAN
Credential: M.D.
Phone: 361-993-8510