Provider Demographics
NPI:1497048839
Name:WEST BELLFORT PEDIATRIC CLINICS, INC.
Entity Type:Organization
Organization Name:WEST BELLFORT PEDIATRIC CLINICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-457-0475
Mailing Address - Street 1:PO BOX 84409
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0014
Mailing Address - Country:US
Mailing Address - Phone:713-457-0475
Mailing Address - Fax:713-457-0499
Practice Address - Street 1:8527 W BELLFORT ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2265
Practice Address - Country:US
Practice Address - Phone:713-457-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty