Healthcare Provider Details

I. General information

NPI: 1982477394
Provider Name (Legal Business Name): TCH PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 N LAKE CREEK PKWY STE 120
AUSTIN TX
78717-6210
US

IV. Provider business mailing address

1919 S BRAESWOOD BLVD STE 5330
HOUSTON TX
77030-4466
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-2999
  • Fax:
Mailing address:
  • Phone: 713-294-7928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA VILLAR
Title or Position: MANAGER
Credential:
Phone: 713-294-7928