Provider Demographics
NPI:1295868842
Name:MOMS2MOMS PEDIATRICS PLLC
Entity type:Organization
Organization Name:MOMS2MOMS PEDIATRICS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:NITZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-219-5550
Mailing Address - Street 1:11851 JOLLYVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-2338
Mailing Address - Country:US
Mailing Address - Phone:512-219-5550
Mailing Address - Fax:512-219-5551
Practice Address - Street 1:11851 JOLLYVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-2338
Practice Address - Country:US
Practice Address - Phone:512-219-5550
Practice Address - Fax:512-219-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty