Provider Demographics
NPI:1639942550
Name:TCH PEDIATRICS INC
Entity Type:Organization
Organization Name:TCH PEDIATRICS INC
Other - Org Name:TCP KYLE CROSSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-824-6631
Mailing Address - Street 1:2040 COLQUITT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3479
Mailing Address - Country:US
Mailing Address - Phone:832-824-6631
Mailing Address - Fax:
Practice Address - Street 1:5120 S. FM 1626 STE 100
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-3394
Practice Address - Country:US
Practice Address - Phone:737-229-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty