Healthcare Provider Details
I. General information
NPI: 1528645645
Provider Name (Legal Business Name): LITTLE PANDAS PEDIATRIC URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3339 FAIRVIEW ST
PASADENA TX
77504-1903
US
IV. Provider business mailing address
702 OLD OYSTER TRL
SUGAR LAND TX
77478-4498
US
V. Phone/Fax
- Phone: 281-300-0836
- Fax:
- Phone: 281-300-0836
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RENE
MAI
Title or Position: CO-OWNER
Credential: MD
Phone: 281-300-0836