Eagle Pass Pediatric Health Clinic – Rural Health Clinic/Center, NPI 1104958081

Eagle Pass Pediatric Health Clinic is a healthcare provider. based in Eagle pass, Texas. specializing in Rural Health Clinic/Center. The organization holds a License No. F3442 (TX). The NPI Number for Eagle Pass Pediatric Health Clinic is 1104958081

Main info

Organization
Name
Eagle Pass Pediatric Health Clinic
NPI
1104958081
Phone
(830) 773-5315
Address
2198 E GARRISON ST STE 2
Authorized Official
DEBRA W DE LOS SANTOS CEO BBA
Enumeration Date
9 March 2007
Last Update Date
7 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness90
Years active:19State licenses:1Digital endpoints

Provider Addresses for Eagle Pass Pediatric Health Clinic

  • 2198 E GARRISON ST STE 2

    EAGLE PASS, TX 788525076

    Phone: (830) 773-5315

    Fax: (830) 757-8366

    Type: Mailing

  • 710 WILLIAMS ST

    EAGLE PASS, TX 788525126

    Phone: (830) 773-1103

    Fax: (830) 757-8366

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20161121001012ORural Health ClinicTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78852)

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Reviews

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Frequently asked questions

Does Eagle Pass Pediatric Health Clinic have a public NPI I can cite?
Public records show Eagle Pass Pediatric Health Clinic under NPI 1104958081.
Is Eagle Pass Pediatric Health Clinic's NPI status active today?
Active status means Eagle Pass Pediatric Health Clinic's NPI record is not deactivated in the public file.
What type of care does Eagle Pass Pediatric Health Clinic provide?
Eagle Pass Pediatric Health Clinic's profile centers on Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Eagle Pass Pediatric Health Clinic?
Eagle Pass Pediatric Health Clinic is associated with Eagle Pass, Texas in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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