Provider Demographics
NPI:1528563780
Name:BELLAIRE PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:BELLAIRE PEDIATRICS, P.A.
Other - Org Name:FAMILY AND CHILDREN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-777-7772
Mailing Address - Street 1:8250 BELLAIRE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4089
Mailing Address - Country:US
Mailing Address - Phone:713-777-7772
Mailing Address - Fax:713-777-8642
Practice Address - Street 1:8250 BELLAIRE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4089
Practice Address - Country:US
Practice Address - Phone:713-777-7772
Practice Address - Fax:713-777-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386303701Medicaid