Provider Demographics
NPI:1396386595
Name:HOPE PEDIATRICS LLC
Entity Type:Organization
Organization Name:HOPE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-714-7422
Mailing Address - Street 1:1904 ARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7707
Mailing Address - Country:US
Mailing Address - Phone:903-714-7422
Mailing Address - Fax:214-396-4678
Practice Address - Street 1:1904 ARRINGTON CT
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7707
Practice Address - Country:US
Practice Address - Phone:214-396-4673
Practice Address - Fax:214-396-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX325639801Medicaid