Provider Demographics
NPI:1861492654
Name:TCH PEDIATRIC ASSOCIATES, INC
Entity Type:Organization
Organization Name:TCH PEDIATRIC ASSOCIATES, INC
Other - Org Name:TCP GRAND PARKWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-824-6602
Mailing Address - Street 1:PO BOX 841969
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1969
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2819 IMPERIAL DRIVE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7903
Practice Address - Country:US
Practice Address - Phone:281-494-8687
Practice Address - Fax:281-494-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty