Healthcare Provider Details

I. General information

NPI: 1457215956
Provider Name (Legal Business Name): TCH PEDIATRIC ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 UNIVERSITY DR E
BRYAN TX
77802-3475
US

IV. Provider business mailing address

3201 UNIVERSITY DR E
BRYAN TX
77802-3475
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-2999
  • Fax:
Mailing address:
  • Phone:
  • 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: KELLEY WHITE
Title or Position: PROVIDER RELATIONS
Credential:
Phone: 832-828-3660