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General NPI Number Information
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NPI Number | 1598357998
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Entity Type | Organization
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Legal Business Name | PEDIATRIC CARDIOLOGY CONSULTANTS OF SOUTH TEXAS
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 11485 TOEPPERWEIN RD STE 2
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City | LIVE OAK
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State | TX
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Zip | 78233-3144
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Country | US
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Telephone | 210-372-7238
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Fax |
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Provider Business Mailing Address
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Address Line | 11485 TOEPPERWEIN RD STE 2
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City | LIVE OAK
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State | TX
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Zip | 78233-3144
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. OLAWALE OLABIYI
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Credential |
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Telephone | 210-655-4278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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