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General NPI Number Information
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NPI Number | 1255522447
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Entity Type | Individual
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Provider Name | LATRESHA J MCBRIDE MD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 300 E HOUSTON, STE A
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City | CLEVELAND
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State | TX
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Zip | 77327
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Country | US
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Telephone | 281-592-9775
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Fax | 281-432-0548
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Provider Business Mailing Address
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Address Line | 108 S WILLIAM BARNETT AVE
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City | CLEVELAND
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State | TX
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Zip | 77327
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Country | US
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Telephone | 281-659-2355
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Fax | 281-592-1570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | BP1-0029095
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N5851
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License Number State | TX
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