Provider Demographics
NPI:1447768759
Name:KIDS GI KARE PLLC
Entity Type:Organization
Organization Name:KIDS GI KARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALABD ALRAZZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-456-4575
Mailing Address - Street 1:27700 HIGHWAY 290 STE 355
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6766
Mailing Address - Country:US
Mailing Address - Phone:281-456-4575
Mailing Address - Fax:281-940-2665
Practice Address - Street 1:27700 HIGHWAY 290 STE 355
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:281-456-4575
Practice Address - Fax:281-940-2665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-21
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP81092080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP8109OtherTEXAS MEDICAL LICENSE
TX3850406Medicaid