Healthcare Provider Details
I. General information
NPI: 1194964767
Provider Name (Legal Business Name): MEMORIAL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4024 BROOKHAVEN AVE
PASADENA TX
77504-1902
US
IV. Provider business mailing address
13630 BEAMER RD
HOUSTON TX
77089-6069
US
V. Phone/Fax
- Phone: 713-944-2324
- Fax: 713-944-1539
- Phone: 281-484-6060
- Fax: 281-484-6064
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | F7977 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
KARIM
H.
ROMMAN
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 281-484-6060