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General NPI Number Information
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NPI Number | 1821612276
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Entity Type | Organization
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Legal Business Name | RAINBOW PEDIATRICS OF HOUSTON, PLLC.
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 12822 VETERANS MEMORIAL DR
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City | HOUSTON
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State | TX
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Zip | 77014-2049
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Country | US
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Telephone | 832-779-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 18511 CABANISS CIR
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City | SPRING
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State | TX
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Zip | 77379-8860
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Country | US
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Telephone | 917-902-0716
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LISA TAK-HING LAU
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Credential | MD
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Telephone | 917-902-0716
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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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