REHOBOTH MEDICAL CENTER LLC (NPI# 1255977583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255977583 |
| Entity Type | Organization |
| Organization Name | REHOBOTH MEDICAL CENTER LLC |
| Practice Address |
25231 Roesner Ln Katy TX 77494-5537 |
| Practice Telephone | 2815067412 |
| Practice Fax Number | 2815302882 |
| Mailing Telephone | 2815067412 |
| Mailing Fax Number | 2815302882 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | STELLA GRACE IMMANUEL (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2815067412 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Rehoboth Pediatric Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980270 | Rehoboth Medical Center LLC | Nurse Practitioner | 14446 Layhill Rd, Silver Spring, MD 20906-1911 | 2019-12-23 |
| Street Address |
25231 ROESNER LN |
| City | KATY |
| State | TX |
| Zip Code | 77494-5537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902947120 | Stella Grace Immanuel | Family Medicine | 25231 Roesner Ln, Katy, TX 77494-5537 | 2007-02-09 |
| 1700425188 | Rehoboth Medical Clinics Pllc | Pediatrics | 25231 Roesner Ln, Katy, TX 77494-5537 | 2020-01-02 |
| 1386288116 | Rehoboth Medical Center Pllc | Pediatrics | 25231 Roesner Ln, Katy, TX 77494-5537 | 2019-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649880899 | Julie Dyan Meyers | Speech-Language Pathologist | 4747 Fm 1463 Suite 900, Katy, TX 77494 | 2020-08-03 |
| 1235763426 | Lucy J Pena | Technician | 28106 Sugarside Glen Dr, Katy, TX 77494 | 2020-02-26 |
| 1063042455 | Wonace LLC | Durable Medical Equipment & Medical Supplies | 2717 Commercial Blvd, E200, Katy, TX 77494 | 2020-01-24 |
| 1801431002 | Justin Lee Landers | Specialist/Technologist | 2818 Fair Chase, Katy, TX 77494 | 2019-11-12 |
| 1285276006 | Chrysalis Group LLC | Pharmacy | 1259 Fm 1463 Suite 700, Katy, TX 77494 | 2019-10-14 |
| 1033760400 | Aaron Moniotte | Pharmacist | 23331 Grand Reserve Dr, Katy, TX 77494 | 2019-09-26 |
| 1467001743 | Julie Hankinson | Technician | 4903 Surrey Park Circle, Katy, TX 77494 | 2019-09-09 |
| 1710532148 | Icome2u Nursing Providers Inc | Nurse Practitioner | 26307 Sundown Cove Lane, Katy, TX 77494 | 2019-08-02 |
| 1881252203 | Encompass Health Rehabilitation Hospital of Katy, LLC | Rehabilitation Hospital | 23331 Grand Reserve Drive, Katy, TX 77494 | 2019-05-31 |
| 1407312945 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 322 Cane Island Pkwy, Katy, TX 77494 | 2019-02-20 |
| Find all providers in zip 77494 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262695 | Buttercup Pediatrics Pllc | Pediatrics | 27524 Westridge Creek Ln Ste D, Katy, TX 77494-5290 | 2020-10-12 |
| 1346726585 | Ut Physicians Specialty Services | Pediatrics | 5503 Fry Rd, Katy, TX 77449 | 2018-07-11 |
| 1285141309 | Newborn and Pediatric Care of West Houston Pllc | Pediatrics | 636 Peek Rd, Katy, TX 77450-3186 | 2018-01-10 |
| 1922528165 | Ut Physicians | Pediatrics | 23960 Katy Fwy Ste 160, Katy, TX 77494-0891 | 2017-06-20 |
| 1649624636 | Kristen Diao | Pediatrics | 23960 Katy Fwy Ste 300, Katy, TX 77494-0887 | 2016-04-16 |
| 1073986352 | Just for Kids Pediatrics Pllc | Pediatrics | 418 Park Grove, Katy, TX 77450 | 2015-11-09 |
| 1891161626 | Springtime Pediatrics | Pediatrics | 23530 Kingsland Blvd., Ste. 100, Katy, TX 77494 | 2015-08-17 |
| 1831576925 | Enrique Gonzales Jr. | Pediatrics | 5502 1st St, Katy, TX 77493-2472 | 2015-04-28 |
| 1407242159 | Emily Claire Fong | Pediatrics | 23960 Katy Fwy Ste 250, Katy, TX 77494 | 2015-04-09 |
| 1710232293 | Brittany Faron | Pediatrics | 10450 Spring Green Blvd, Suite B, Katy, TX 77494-5908 | 2012-07-19 |
| Find all providers in KATY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.