MEDICARE: LITTLE STARS PEDIATRIC CENTER THE WOODLANDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM3000X	Medically Fragile Infants and Children Day Care

General Provider Information

NPI Number	:	1043172786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE STARS PEDIATRIC CENTER THE WOODLANDS LLC

Provider Business Mailing Address
First Line	:	10815 KUYKENDAHL RD
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-2777
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10815 KUYKENDAHL RD
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-2777
Country	:	US
Telephone Number	:	786-389-2248
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARLOS RUIZ
Credential	:	PA-C
Telephone Number	:	786-389-2248

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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