NACOGDOCHES PEDIATRIC CARE (NPI# 1518440494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518440494 |
| Entity Type | Organization |
| Organization Name | NACOGDOCHES PEDIATRIC CARE |
| Practice Address |
124 Creekbend Blvd Nacogdoches TX 75965-1780 |
| Mailing Address |
2407 Pinehurst Dr Monroe LA 71201-2314 |
| Practice Telephone | 1936234085 |
| Mailing Telephone | 3183485945 |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |
| Authorized Official Name | MISTI HAJJ (OWNER) |
| Authorized Official Telephone | 3183485945 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM3000X |
Clinic/Center Specialization: Medically Fragile Intants and Children Day Care |
Ambulatory Health Care Facilities |
| Street Address |
124 CREEKBEND BLVD |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-1780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 261QM3000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medically Fragile Intants and Children Day Care |
| An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410087 | Beautiful Eden LLC | Clinic/Center | 3410 Cabernet Shores Dr, Fulshear, TX 77441-1918 | 2020-09-04 |
| 1114552346 | Rgv Kidz Place, LLC | Clinic/Center | 2722 Fountain Plaza Blvd, Edinburg, TX 78539-8030 | 2020-03-09 |
| 1760047146 | Only Love Pediatric Day Health Center | Clinic/Center | 5500 N 29th St, Mcallen, TX 78504-5109 | 2019-05-01 |
| 1346758844 | Little Haven Ppecc LLC | Clinic/Center | 328 Lorenaly Dr, Suite 100, Brownsville, TX 78526 | 2018-01-18 |
| 1568971752 | Caring Hands Ppecc of Texas, LLC. | Clinic/Center | 1028 E Idel St, Tyler, TX 75701-2024 | 2017-09-20 |
| 1588194302 | At Lalas Place LLC | Clinic/Center | 4713 Parkhaven Dr, Garland, TX 75043-7577 | 2017-06-14 |
| 1154816908 | Lauves Ppecc LLC | Clinic/Center | 403 Enterprise St, Longview, TX 75604-5463 | 2018-06-25 |
| City | NACOGDOCHES |
| Zip Code | 75965 |
Please comment or provide details below to improve the information on NACOGDOCHES PEDIATRIC CARE.
| 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.