National Provider Identifier Database

NACOGDOCHES PEDIATRIC CARE
Medically Fragile Infants 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.).


Contact Information

NACOGDOCHES PEDIATRIC CARE
124 CREEKBEND BLVD
NACOGDOCHES, TX75965-1780
Phone: 193-623-4085
Fax:
Website:
Specialty Taxonomy Code
* Medically Fragile Infants and Children Day Care 261QM3000X

* Indicates primary specialty

NPI Profile & details for NACOGDOCHES PEDIATRIC CARE

NPI Number 1518440494
Legal business name
LBN
NACOGDOCHES PEDIATRIC CARE
Authorized official MISTI HAJJ - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/07/2018
Last updated 08/17/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • TX Medicaid: 4053464

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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