Northside Pediatrics Associates, PA
Pediatrics in Conroe, TX. Organization (NPI-2).
NPI number1669928883
StatusActive
Last updated in NPPESApr 19, 2017
Details
- NPI
- 1669928883
- Entity type
- Organization (NPI-2)
- Legal business name
- Northside Pediatrics Associates, PA
- Organization subpart
- No
- Enumeration date
- Aug 28, 2016
- Last updated
- Apr 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | K4516 | TX | Yes |
Practice location
15210 I-45 SouthSuite 110
Conroe, TX 77384-4105
Phone 936-270-8655
Mailing address
15210 I-45 SSuite 110
Conroe, TX 77384-4105
Phone 936-270-8655 · Fax 936-270-8739
Authorized official
Michael E Okogbo
Owner
8066263808
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