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General NPI Number Information
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NPI Number | 1871557132
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Entity Type | Organization
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Legal Business Name | THE CHILDRENS DOCTOR
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18 PASEO PLZ
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City | BROWNSVILLE
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State | TX
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Zip | 78526-1602
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Country | US
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Telephone | 956-982-1561
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Fax | 956-982-0498
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Provider Business Mailing Address
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Address Line | 18 PASEO PLAZA
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City | BROWNSVILLE
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State | TX
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Zip | 78526-1602
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Country | US
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Telephone | 956-982-1561
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Fax | 956-982-0498
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MIRIAM Y THURBER
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Credential |
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Telephone | 956-982-1561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | H8864
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License Number State | TX
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