Provider Demographics
NPI:1790188027
Name:PEDIATRICS OF GREATER HOUSTON, PLLC
Entity Type:Organization
Organization Name:PEDIATRICS OF GREATER HOUSTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-944-1716
Mailing Address - Street 1:7900 FANNIN ST
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-630-0669
Mailing Address - Fax:
Practice Address - Street 1:7900 FANNIN ST
Practice Address - Street 2:SUITE 3300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-630-0669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty