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General NPI Number Information
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NPI Number | 1114049244
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Entity Type | Organization
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Legal Business Name | WEST HOUSTON PEDIATRIC ASSOC PA
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12606 WEST HOUSTON CENTER BLVD STE 280
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City | HOUSTON
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State | TX
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Zip | 77082-2760
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Country | US
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Telephone | 281-496-7093
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Fax | 281-496-1538
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Provider Business Mailing Address
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Address Line | 12606 WEST HOUSTON CENTER BLVD STE 280
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City | HOUSTON
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State | TX
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Zip | 77082-2760
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Country | US
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Telephone | 281-496-7093
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Fax | 281-496-1538
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GEORGIA LEE TAYLOR
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Credential |
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Telephone | 281-496-7093
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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 | H0883
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License Number State | TX
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