MEDICARE: LITTLE STARS PEDIATRIC CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	315P00000X	Intellectual Disabilities Intermediate Care Facility
2	314000000X	Skilled Nursing Facility
3	313M00000X	Nursing Facility/Intermediate Care Facility
4	251G00000X	Community Based Hospice Care Agency
5	261QD1600X	Developmental Disabilities Clinic/Center
6	252Y00000X	Early Intervention Provider Agency
7	251C00000X	Developmentally Disabled Services Day Training Agency
8	251J00000X	Nursing Care Agency
9	261QA0600X	Adult Day Care Clinic/Center
10	376J00000X	Homemaker
11	3140N1450X	Pediatric Skilled Nursing Facility
12	261QM3000X	Medically Fragile Infants and Children Day Care

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528953684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE STARS PEDIATRIC CENTER LLC

Provider Business Mailing Address
First Line	:	3301 PLAINVIEW ST STE 10
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1927
Country	:	US
Telephone Number	:	786-389-2248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 PLAINVIEW ST STE 10
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1927
Country	:	US
Telephone Number	:	786-389-2248
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CARLOS RUIZ
Credential	:	PA-C
Telephone Number	:	786-389-2248

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	03/12/2026

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