Provider Demographics
NPI:1801045604
Name:HOBERT PEDIATRICS
Entity Type:Organization
Organization Name:HOBERT PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC/SLP
Authorized Official - Phone:972-386-7086
Mailing Address - Street 1:PMB 138
Mailing Address - Street 2:3948 LEGACY DRIVE STE 106
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023
Mailing Address - Country:US
Mailing Address - Phone:972-386-7086
Mailing Address - Fax:972-386-4373
Practice Address - Street 1:12860 HILLCREST RD
Practice Address - Street 2:SUITE 217
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:972-386-7086
Practice Address - Fax:972-386-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0084KXOtherBLUE CROSS BLUE SHIELD