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General NPI Number Information
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NPI Number | 1083627103
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Entity Type | Organization
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Legal Business Name | HANISSIAN PEDIATRICS, PLLC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 9809 ROWLETT RD SUITE A1
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City | HOUSTON
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State | TX
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Zip | 77075-3403
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Country | US
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Telephone | 713-644-1119
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Fax | 713-644-0900
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Provider Business Mailing Address
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Address Line | 9809 ROWLETT RD SUITE A1
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City | HOUSTON
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State | TX
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Zip | 77075-3403
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Country | US
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Telephone | 713-644-1119
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Fax | 713-644-0900
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. TALYNN A HANISSIAN
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Credential | M.D.
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Telephone | 713-644-1119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | H8677
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License Number State | TX
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