Basic Information
| Provider Information | |||||||||
| NPI: | 1225038326 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TCH PEDIATRIC ASSOCIATES, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TEXAS CHILDREN'S PEDIATRIC ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8080 N STADIUM DR | ||||||||
| Address2: | 200 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770541829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328246633 | ||||||||
| FaxNumber: | 8328258901 | ||||||||
| Practice Location | |||||||||
| Address1: | 8080 N STADIUM DR | ||||||||
| Address2: | 200 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770541829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8328246633 | ||||||||
| FaxNumber: | 8328258901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | GARZA | ||||||||
| AuthorizedOfficialFirstName: | ANNETTE | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | CONTRACT ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8328246633 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.