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General NPI Number Information
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NPI Number | 1649300278
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Entity Type | Organization
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Legal Business Name | HELOTES PEDIATRICS, P.A.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 12274 BANDERA RD SUITE 106
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City | HELOTES
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State | TX
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Zip | 78023-4385
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Country | US
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Telephone | 210-372-0505
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Fax | 210-372-0404
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Provider Business Mailing Address
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Address Line | 12274 BANDERA RD SUITE 106
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City | HELOTES
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State | TX
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Zip | 78023-4385
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Country | US
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Telephone | 210-372-0505
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Fax | 210-372-0404
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | BECKY BARA
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Credential |
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Telephone | 210-372-0505
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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 | TX
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