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SOUTHEAST TEXAS PEDIATRIC CENTER PA
NPI 1720761075
Pediatrics in Nederland, TX

Active since August 11, 2023CLIA 45D2292283 · Waiver
2400 HIGHWAY 365 STE 107, NEDERLAND, TX 77627(409) 729-9200(409) 729-9235 Get Directions Write a Review

NPPES record last updated: September 14, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Southeast Texas Pediatric Center Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST TEXAS PEDIATRIC CENTER PA (NPI 1720761075) is a healthcare organization registered as a pediatrics in Nederland, Texas and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through October 23, 2027, maintains a secondary practice location in Port Arthur, and lists Roberto Mayor, Administrator, as its authorized official.

NPPES Registry Identity

NPI1720761075
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSOUTHEAST TEXAS PEDIATRIC CENTER PA
Location Address2400 HIGHWAY 365 STE 107Nederland, TX 77627-6268
Mailing Address2400 Highway 365 Ste 107Nederland, TX 77627-6268 · (409) 729-9200 · Fax (409) 729-9235
Phone(409) 729-9200
Fax(409) 729-9235
Organization SubpartNo
Authorized OfficialRoberto MayorAdministrator · (409) 729-9200
Enumeration DateAugust 11, 2023
Last NPPES UpdateSeptember 14, 2023
NPPES CertifiedSeptember 14, 2023
✔ NPI 1720761075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
2400 HIGHWAY 365 STE 107, Nederland, TX 77627
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Other Names 1

Doing Business AsSoutheast Texas Pediatric Center Pa

Secondary Practice Location 1

Location 18333 9th Ave Ste BPort Arthur, TX 77642-8151 · Phone (409) 729-9200

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2292283

Southeast Texas Pediatric Center PA · Nederland, TX
Active · expires Oct 23, 2027
CLIA Number45D2292283
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2025
Certificate Expiration DateOctober 23, 2027
Laboratory DirectorMinda Toledo
Laboratory Phone(409) 729-9200
Laboratory LocationSoutheast Texas Pediatric Center PA2400 Hwy 365 Ste 107, Nederland, TX 77627
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MINDA LAO TOLEDO M.D.
Pediatrics
2400 HIGHWAY 365 STE 107
NEDERLAND, TX 77627
Jefferson County (409) 729-9200
TEEKAM DAS LOHANO MD
Pediatrics
2400 HIGHWAY 365 STE 107
NEDERLAND, TX 77627
Jefferson County (409) 527-9800
TEEKAM LOHANO, MD PA
Pediatrics
2400 HIGHWAY 365 STE 107
NEDERLAND, TX 77627
Jefferson County (409) 527-9800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Texas Pediatric Center PA's NPI number?

The NPI number for Southeast Texas Pediatric Center PA is 1720761075. It was assigned to this organization in the NPPES registry on August 11, 2023.

Where is Southeast Texas Pediatric Center PA located?

Southeast Texas Pediatric Center PA is located at 2400 Highway 365 Ste 107, Nederland, TX 77627. The listed phone number is (409) 729-9200.

What is Southeast Texas Pediatric Center PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Southeast Texas Pediatric Center PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2292283) is associated with this NPI, valid through October 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeast Texas Pediatric Center PA accept?

Health plans from Blue Cross and Blue Shield of Texas list Southeast Texas Pediatric Center PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Texas Pediatric Center PA was last updated on September 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.