PEDIATRIC HEROES PRIMARY CARE CLINIC PLLC NPI 1790374932

NPI Information

PEDIATRIC HEROES PRIMARY CARE CLINIC, PLLC is a pediatrics nurse practitioner in San Antonio, TX. PEDIATRIC HEROES PRIMARY CARE CLINIC, PLLC NPI is 1790374932. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

21970 BULVERDE RD
SAN ANTONIO, TX
ZIP 78259-178
Phone: (240) 605-3767

The provider's authorized official is Marlischa Hall .
The authorized official title is Owner and has the following contact phone number (240) 605-3767.

The CLIA number assigned to this NPI record is 45D2227245 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/12/2021 and was last updated on 1/12/2021.

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:

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