Provider Demographics
NPI:1487779286
Name:ORANGE PEDIATRICS, PA
Entity type:Organization
Organization Name:ORANGE PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:SARDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-886-4242
Mailing Address - Street 1:PO BOX 3101
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77631-3101
Mailing Address - Country:US
Mailing Address - Phone:409-886-4242
Mailing Address - Fax:409-886-2559
Practice Address - Street 1:909 12TH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4906
Practice Address - Country:US
Practice Address - Phone:409-886-4242
Practice Address - Fax:409-886-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1731174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B4020OtherBLUE CROSS
TX8B4020OtherBLUE CROSS