Provider Demographics
NPI:1437575172
Name:THE PEDIATRIC CARE CENTER
Entity Type:Organization
Organization Name:THE PEDIATRIC CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BABINEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:956-263-1830
Mailing Address - Street 1:214 CHAPARRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-4605
Mailing Address - Country:US
Mailing Address - Phone:956-263-1930
Mailing Address - Fax:956-263-1836
Practice Address - Street 1:214 CHAPARRAL BLVD
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-4605
Practice Address - Country:US
Practice Address - Phone:956-263-1830
Practice Address - Fax:956-263-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207981601Medicaid