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General NPI Number Information
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NPI Number | 1225401409
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Entity Type | Organization
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Legal Business Name | LOUETTA PEDIATRICS, PLLC
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 5834 LOUETTA ROAD SUITE G
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City | SPRING
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State | TX
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Zip | 77379
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Country | US
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Telephone | 281-826-0016
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Fax | 281-826-0017
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Provider Business Mailing Address
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Address Line | 5834 LOUETTA ROAD SUITE G
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City | SPRING
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State | TX
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Zip | 77379
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Country | US
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Telephone | 281-826-0016
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Fax | 281-826-0017
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SITTIE RAINNI DIANALAN
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Credential | MD
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Telephone | 281-826-0016
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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 | L8322
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License Number State | TX
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