Basic Information
| Provider Information | |||||||||
| NPI: | 1093249708 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARTNERS IN CARE PEDIATRICS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 GOSWELL LN | ||||||||
| Address2: | |||||||||
| City: | CHANNELVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775302238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138997725 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7918 BROADWAY ST | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775817937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818576171 | ||||||||
| FaxNumber: | 2817832117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2017 | ||||||||
| LastUpdateDate: | 04/19/2017 | ||||||||
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| AuthorizedOfficialLastName: | RUMLEY | ||||||||
| AuthorizedOfficialFirstName: | ANDREA | ||||||||
| AuthorizedOfficialMiddleName: | DEE | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 7138997725 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | N2364 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.