| NPI | 1780717058 |
|---|---|
| Other Name | BCBS - PEDIATRIC SPECIALIST ONLY |
| Entity Type | Organization |
| Authorized Contact | ALICE CANTU Assoc Vice Pres, Rco 254-215-9719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2013-06-11 |