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General NPI Number Information
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NPI Number | 1447768759
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Entity Type | Organization
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Legal Business Name | KIDS GI KARE PLLC
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Dates
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Enumeration Date | 01/21/2018
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 27700 HIGHWAY 290 STE 355
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City | CYPRESS
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State | TX
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Zip | 77433
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Country | US
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Telephone | 281-456-4575
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Fax | 281-940-2665
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Provider Business Mailing Address
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Address Line | 27700 HIGHWAY 290 STE 355
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City | CYPRESS
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State | TX
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Zip | 77433-6766
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Country | US
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Telephone | 281-456-4575
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Fax | 281-940-2665
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARAA ALABD ALRAZZAK
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Credential | MD
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Telephone | 281-456-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | P8109
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License Number State | TX
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