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Shepherds Pediatric Care
Primary Care Clinic/Center in Lake Jackson, Texas
NPI 1790108454

Shepherds Pediatric Care is a Primary Care Clinic/Center based in Lake Jackson, TX and is specialized in Primary Care. Shepherds Pediatric Care practices in Lake Jackson, TX. The NPI Number for Shepherds Pediatric Care is 1790108454 and holds a License No. N6017 (Texas).

The current practice location address for Shepherds Pediatric Care is 106 Circle Way St, Lake Jackson, TX and can be reached out via phone at 979-297-3949 and via fax at 979-297-3919.

Location: 106 Circle Way St, Lake Jackson, TX, 77566-5202
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790108454
Provider Name
Shepherds Pediatric Care
Credential
Provider Entity Type
Organization
Address
106 Circle Way St, Lake Jackson, TX, 77566-5202
Phone Number
979-297-3949
Fax Number
979-297-3919
Provider Enumeration Date
01/30/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
214871001 05 TX
institution
Provider Business Practice Location Address Details
Address
106 Circle Way St
City
Lake Jackson
State
Texas
Zip
77566-5202
Phone Number
979-297-3949
Fax Number
979-297-3919
person
Provider Business Mailing Address Details
Address
106 Circle Way St
City
Lake Jackson
State
Texas
Zip
77566-5202
Phone Number
979-297-3949
Fax Number
979-297-3919
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
N6017 (Texas)
Definition
Definition to come...
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