Provider Demographics
NPI:1710034962
Name:ABC PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:ABC PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-853-3222
Mailing Address - Street 1:3533 S ALAMEDA ST
Mailing Address - Street 2:#303, JOSEPH M. SLOAN MEDICAL BLDG.
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-853-3222
Mailing Address - Fax:361-561-2692
Practice Address - Street 1:3533 S ALAMEDA ST
Practice Address - Street 2:#303, JOSEPH M. SLOAN MEDICAL BLDG.
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-853-3222
Practice Address - Fax:361-561-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB87576Medicare UPIN
TXE88559Medicare UPIN
TXC16400Medicare UPIN
TXC13905Medicare UPIN
TXH68624Medicare UPIN
TXE75302Medicare UPIN
TXG50563Medicare UPIN
TXH75296Medicare UPIN