=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023989522
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUMMINGBIRD PEDIATRIC HEALTH, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 W. DALLAS ST., SUITE A&B
-----------------------------------------------------
City | LLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-322-2473
-----------------------------------------------------
Fax | 325-248-6379
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 102 W. DALLAS ST., SUITE A&B
-----------------------------------------------------
City | LLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-322-2473
-----------------------------------------------------
Fax | 325-248-6379
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | DANA POCASANGRE
-----------------------------------------------------
Credential | FNP-C
-----------------------------------------------------
Telephone | 210-643-8974
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------