PREMIER PEDIATRICS OF HOUSTON NPI 1811235674

NPI Information

NPI: 1811235674
Provider Name: PREMIER PEDIATRICS OF HOUSTON
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 45D2057015

Address:
2128 SPEARS RD
SUITE 300
HOUSTON, TX
ZIP 77067
Phone: (281) 979-2112
Get Directions

PREMIER PEDIATRICS OF HOUSTON is a pediatrics nurse practitioner in Houston, TX. PREMIER PEDIATRICS OF HOUSTON NPI is 1811235674. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2128 SPEARS RD
SUITE 300
HOUSTON, TX
ZIP 77067-320
Phone: (281) 979-2112
Fax: (281) 884-3558

The provider's authorized official is Tamecka Knight .
The authorized official title is Owner and has the following contact phone number (281) 979-2112.

The CLIA number assigned to this NPI record is 45D2057015 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2013 and was last updated on 6/16/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	363LP0200X	Nurse Practitioner	Pediatrics	20030764	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3117269-01	MEDICAID	TEXAS
2	3117269-03	OTHER	TEXAS	TX HEALTH STEPS
3	3117269-02	OTHER	TEXAS	CSHCN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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