Healthcare Provider Details

I. General information

NPI: 1659552883
Provider Name (Legal Business Name): RIVER OAKS PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 W ALABAMA ST SUITE B
HOUSTON TX
77098-1701
US

IV. Provider business mailing address

3275 W ALABAMA ST SUITE B
HOUSTON TX
77098-1701
US

V. Phone/Fax

Practice location:
  • Phone: 713-524-4477
  • Fax: 713-524-9977
Mailing address:
  • Phone: 713-524-4477
  • Fax: 713-524-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL6428
License Number StateTX

VIII. Authorized Official

Name: DR. BAMBI LYNN HOEFNER
Title or Position: MEDICAL DOCTOR /OWNER OF PRACTICE
Credential: M.D.
Phone: 713-524-4477