Healthcare Provider Details

I. General information

NPI: 1427170075
Provider Name (Legal Business Name): SOUTH TEXAS PSYCHIATRIC ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 WEBER ROAD
CORPUS CHRISTI TX
78411-3603
US

IV. Provider business mailing address

4234 WEBER ROAD
CORPUS CHRISTI TX
78411-3603
US

V. Phone/Fax

Practice location:
  • Phone: 361-857-2090
  • Fax: 361-814-6302
Mailing address:
  • Phone: 361-857-2090
  • Fax: 361-814-6302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROSS L ROBLES
Title or Position: OFFICE MANAGER
Credential:
Phone: 361-857-2090