Provider Demographics
NPI:1982104204
Name:TCH PEDIATRICS INC
Entity Type:Organization
Organization Name:TCH PEDIATRICS INC
Other - Org Name:TCP - PEDIATRICS OF AUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-447-5588
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:832-824-6631
Mailing Address - Fax:
Practice Address - Street 1:5625 EIGER RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8977
Practice Address - Country:US
Practice Address - Phone:832-824-6631
Practice Address - Fax:832-825-8901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TCH PEDIATRIC ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-13
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty