MEDICARE: TEXAS TOP PEDIATRICS PA

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	:	1760105688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS TOP PEDIATRICS PA

Provider Business Mailing Address
First Line	:	2612 PORTLAND AVE
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-1714
Country	:	US
Telephone Number	:	347-276-9265
Fax Number	:

Provider Business Practice Location Address
First Line	:	2343 NW MILITARY HWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78231-2502
Country	:	US
Telephone Number	:	347-276-9265
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	OSMAN KHAIR
Credential	:
Telephone Number	:	347-276-9265

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	09/26/2022

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Directions to “TEXAS TOP PEDIATRICS PA ” Practice Location

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