Provider Demographics
NPI:1659552883
Name:RIVER OAKS PEDIATRICS, PA
Entity type:Organization
Organization Name:RIVER OAKS PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR /OWNER OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:BAMBI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOEFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-524-4477
Mailing Address - Street 1:3275 W ALABAMA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1701
Mailing Address - Country:US
Mailing Address - Phone:713-524-4477
Mailing Address - Fax:713-524-9977
Practice Address - Street 1:3275 W ALABAMA ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1701
Practice Address - Country:US
Practice Address - Phone:713-524-4477
Practice Address - Fax:713-524-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6428208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S4770OtherBCBS PROVIDER NUMBER