Provider Demographics
NPI:1407347081
Name:PLAYHOUSE PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:PLAYHOUSE PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-245-7317
Mailing Address - Street 1:5330 N MACARTHUR BLVD # 154-120
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8788
Mailing Address - Country:US
Mailing Address - Phone:909-238-6606
Mailing Address - Fax:
Practice Address - Street 1:1407 AVENUE H
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3529
Practice Address - Country:US
Practice Address - Phone:979-245-7317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-19
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care