Organization · NPI-2
Pediatric Immediate Care Of Texas, PLLC
Pediatrics · League City, TX
NPI number1083156905
StatusActive
Last updated in NPPESFeb 24, 2022
Details
- NPI
- 1083156905
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Immediate Care Of Texas, PLLC
- Organization subpart
- No
- Enumeration date
- Nov 9, 2016
- Certification date
- Feb 24, 2022
- Last updated
- Feb 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | – | – | |
| 2080P0204X | Pediatrics, Pediatric Emergency Medicine | – | – |
Practice location
3831 E League City PkwySuite A
League City, TX 77573-7155
Phone 281-515-2643
Mailing address
3831 E League City PkwySuite A
League City, TX 77573-7155
Authorized official
Rami Sunallah
Owner
2815152643
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