Provider Demographics
NPI:1235565458
Name:CHRISCILLIA PEDIATRIC CARE INCORPORATED
Entity Type:Organization
Organization Name:CHRISCILLIA PEDIATRIC CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADIMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MADUEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-664-1673
Mailing Address - Street 1:6006 BELLAIRE BLVD
Mailing Address - Street 2:STE 218
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5404
Mailing Address - Country:US
Mailing Address - Phone:713-664-1673
Mailing Address - Fax:713-664-1674
Practice Address - Street 1:6006 BELLAIRE BLVD
Practice Address - Street 2:STE 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5404
Practice Address - Country:US
Practice Address - Phone:713-664-1673
Practice Address - Fax:713-664-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health