Provider Demographics
NPI:1437495835
Name:TEXAS CHILDREN'S HEALTH PLAN - THE CENTER
Entity Type:Organization
Organization Name:TEXAS CHILDREN'S HEALTH PLAN - THE CENTER
Other - Org Name:TEXAS CHILDREN'S HEALTH PLAN - THE CENTER FOR CHILDREN AND WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR / DELEGATE OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-828-1354
Mailing Address - Street 1:PO BOX 301011
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 N SAM HOUSTON PKWY W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-4335
Practice Address - Country:US
Practice Address - Phone:832-828-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS CHILDREN'S HEALTH PLAN INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-13
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty