Healthcare Provider Details

I. General information

NPI: 1831261478
Provider Name (Legal Business Name): PEDIATRIC JUNCTION, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 KOHLERS CROSSING SUITE 310
KYLE TX
78640
US

IV. Provider business mailing address

115 KOHLERS CROSSING SUITE 310
KYLE TX
78640
US

V. Phone/Fax

Practice location:
  • Phone: 512-312-5312
  • Fax: 512-312-5313
Mailing address:
  • Phone: 512-312-5312
  • Fax: 512-312-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANNA LINCOLN
Title or Position: OWNER
Credential: MD
Phone: 512-312-5312