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General NPI Number Information
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NPI Number | 1871246710
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Entity Type | Organization
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Legal Business Name | TCH PEDIATRIC ASSOCIATES, INC.
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 103 12TH ST STE 101
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-3814
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Country | US
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Telephone | 512-989-3334
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Fax | 512-989-3390
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Provider Business Mailing Address
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Address Line | 1919 S BRAESWOOD BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-4444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LAURA VILLAR
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Credential |
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Telephone | 832-824-2999
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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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