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General NPI Number Information
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NPI Number | 1528142296
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Entity Type | Organization
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Legal Business Name | NORTHEAST PEDIATRICS ASSOCIATES OF HUMBLE
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 E MAIN ST
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City | HUMBLE
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State | TX
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Zip | 77338-4513
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Country | US
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Telephone | 281-548-7334
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Fax | 281-548-7363
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Provider Business Mailing Address
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Address Line | 104 MAIN ST
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City | HUMBLE
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State | TX
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Zip | 77338
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Country | US
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Telephone | 281-548-7334
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Fax | 281-548-7363
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Authorized Official
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Title or Position | FINANCIAL MANAGER
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Name | MS. SANDRA L SOLIS
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Credential |
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Telephone | 281-548-7334
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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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