MEDICARE: HG PEDIATRICS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1568816726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HG PEDIATRICS, PLLC

Provider Business Mailing Address
First Line	:	5090 RICHMOND AVE
Second Line	:	SUITE 492
City	:	HOUSTON
State	:	TX
Zip	:	77056-7402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 NORTH LOOP W STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1366
Country	:	US
Telephone Number	:	713-208-4562
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HOMERO GARZA
Credential	:	MD
Telephone Number	:	713-208-4562

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	05/05/2017

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