Provider Demographics
NPI:1952670465
Name:HEALTHY FUTURES PEDIATRICS OF HUTTO, LLC
Entity Type:Organization
Organization Name:HEALTHY FUTURES PEDIATRICS OF HUTTO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-368-0200
Mailing Address - Street 1:210 HWY 79
Mailing Address - Street 2:STE. 104
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4533
Mailing Address - Country:US
Mailing Address - Phone:512-368-0200
Mailing Address - Fax:
Practice Address - Street 1:210 HWY 79
Practice Address - Street 2:STE. 104
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-4533
Practice Address - Country:US
Practice Address - Phone:512-368-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX709535363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty