Provider Demographics
NPI:1366688533
Name:HOUSTON PEDIATRIC CENTER, PA
Entity type:Organization
Organization Name:HOUSTON PEDIATRIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:BABAR
Authorized Official - Last Name:RAJPUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-444-7337
Mailing Address - Street 1:17070 RED OAK DR STE 409
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2617
Mailing Address - Country:US
Mailing Address - Phone:281-444-7337
Mailing Address - Fax:281-444-4559
Practice Address - Street 1:17070 RED OAK DR STE 409
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2617
Practice Address - Country:US
Practice Address - Phone:281-444-7337
Practice Address - Fax:281-444-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X
TXM7550261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194698002Medicaid