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General NPI Number Information
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NPI Number | 1396410528
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Entity Type | Organization
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Legal Business Name | ICARE PEDIATRICS PLLC
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 218 W NASA PKWY STE B
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City | WEBSTER
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State | TX
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Zip | 77598-5208
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Country | US
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Telephone | 832-301-1856
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Fax | 713-554-2045
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Provider Business Mailing Address
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Address Line | 9 PROFESSIONAL PARK DR STE 9C
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City | WEBSTER
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State | TX
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Zip | 77598-4142
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Country | US
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Telephone | 832-284-7083
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Fax | 281-525-4123
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. LA TOSHA N HOLMES
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Credential | NURSE PRACTITIONER
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Telephone | 832-301-1856
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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 |
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License Number State |
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