HOUSTON AREA PEDIATRIC NEUROLOGY PLLC - NPI NUMBER 1093056608

Summary

Provider Name: HOUSTON AREA PEDIATRIC NEUROLOGY PLLC

NPI Number: 1093056608

Clasification: Pediatrics (2080P0008X)

Specialization: Neurodevelopmental Disabilities

Address:
17510 W GRAND PKWY S
SUITE 440
SUGAR LAND, TX
ZIP 77479

Phone Number: (832) 471-6248



Detailed Information

HOUSTON AREA PEDIATRIC NEUROLOGY PLLC is a neurodevelopmental disabilities pediatrician in Sugar Land, TX. The provider is a pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. The assigned NPI number for this provider is 1093056608 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

17510 W GRAND PKWY S
SUITE 440
SUGAR LAND, TX
ZIP 77479-645
Phone: (832) 471-6248
Fax: (832) 471-6984

The provider's authorized official is Melissa Jones .
The authorized official title is President and has the following contact phone number (832) 471-6248.

The enumeration date for this NPI number is 3/6/2013 and was last updated on 3/6/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2080P0008X Pediatrics Neurodevelopmental Disabilities No
2 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1093056608 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name HOUSTON AREA PEDIATRIC NEUROLOGY PLLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 17510 W GRAND PKWY S The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 440 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name SUGAR LAND The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name TX The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 774792645 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 8324716248 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 8324716984 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 3/6/2013 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 3/6/2013 The date that a record was last updated or changed.
15 Authorized Official Last Name JONES The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name MELISSA The first name of the authorized official.
17 Authorized Official Title or Position PRESIDENT The title or position of the authorized official.
18 Authorized Official Telephone Number 8324716248 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 2080P0008X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 2084N0402X
22 Healthcare Provider Primary Taxonomy Switch 2 Y
23 Is Organization Subpart N
24 Authorized Official Credential Text MD
25 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
26 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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