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General NPI Number Information
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NPI Number | 1679116750
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Entity Type | Organization
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Legal Business Name | PEDIATRIC & ADOLESCENT MEDICINE, PLLC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 302 LORENALY DR STE G
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4332
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Country | US
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Telephone | 956-801-2501
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Fax | 956-801-2504
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Provider Business Mailing Address
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Address Line | 302 LORENALY DR STE G
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4332
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Country | US
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Telephone | 956-801-2501
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Fax | 956-801-2504
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Authorized Official
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Title or Position | OWNER
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Name | NEJEMIE ALTER
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Credential | MD
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Telephone | 361-739-7874
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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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