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MODERN PEDIATRICS PROFESSIONALS PLLC NPI 1154952505


NPI Information

NPI: 1154952505
Provider Name: MODERN PEDIATRICS PROFESSIONALS, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D2180634

Address:
2309 SANTA MARIA ST
AUSTIN, TX
ZIP 78702
Phone: (319) 541-7604
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MODERN PEDIATRICS PROFESSIONALS, PLLC is a pediatrics in Austin, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MODERN PEDIATRICS PROFESSIONALS, PLLC NPI is 1154952505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2309 SANTA MARIA ST
AUSTIN, TX
ZIP 78702-617
Phone: (319) 541-7604

The provider's authorized official is Timothy James Porter .
The authorized official title is Chief Medical Officer and has the following contact phone number (319) 541-7604.

The CLIA number assigned to this NPI record is 45D2180634 - other - house-calls only with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/3/2020 and was last updated on 2/3/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

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

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