MEDICARE: TCH PEDIATRICS INC

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1497368591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TCH PEDIATRICS INC

Provider Business Mailing Address
First Line	:	8080 N STADIUM DR STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1877
Country	:	US
Telephone Number	:	832-824-6631
Fax Number	:

Provider Business Practice Location Address
First Line	:	4207 JAMES CASEY ST STE 111
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-3362
Country	:	US
Telephone Number	:	512-444-9800
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LAURA VILLAR
Credential	:
Telephone Number	:	832-824-6631

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	08/28/2020

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Directions to “TCH PEDIATRICS INC ” Practice Location

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