Developmental Pediatric Medicine

Office: (361) 694-5650
Fax: (361) 808-2063

Fax information required by referring physician:

  • Referral Request Form (Script signed by PCP and must have ICD 10 codes)
  • Patient must be referred by Primary Care Physician
  • Insurance/Medicaid Card (Front & Back)
  • Demographic Information
  • Physician’s notes/diagnosis
  • Please note: two or more complex Dx required for patient referral.
  • Referral age is toddler to 12 years old.
  • The only Medicaid insurance accepted are Driscoll Health Plan and TMHP Medicaid. All other private insurance is Out of Network.
  • All services are only for short term.

For suspected but not yet diagnosed referral for Autism, please send screening results for Autism. Exp. - (MCHAT)

Patient must bring to appointment:

  • Patient must be accompanied by parent/guardian (with ID) who knows the history
  • Immunization card
  • Report cards to first visit
  • Current medications