Provider Demographics
NPI:1043746654
Name:NIGHTLIGHT AFTER HOURS PEDIATRICS PLLC
Entity Type:Organization
Organization Name:NIGHTLIGHT AFTER HOURS PEDIATRICS PLLC
Other - Org Name:NIGHTLIGHT PEDIATRIC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-202-6285
Mailing Address - Street 1:1814 FOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1814 FOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3004
Practice Address - Country:US
Practice Address - Phone:713-957-2020
Practice Address - Fax:281-325-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care