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General NPI Number Information
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NPI Number | 1659426344
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Entity Type | Organization
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Legal Business Name | KIDS 'N TEENS CLINICS
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2925 W T C JESTER BLVD STE. 1
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City | HOUSTON
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State | TX
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Zip | 77018-7061
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Country | US
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Telephone | 713-681-7334
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 W T C JESTER BLVD STE. 1
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City | HOUSTON
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State | TX
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Zip | 77018-7061
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Country | US
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Telephone | 713-681-7334
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | FERNANDO ISART
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Credential | M.D.
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Telephone | 713-681-7334
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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 | K1572
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License Number State | TX
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