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Contact Information

NACOGDOCHES PEDIATRIC CARE
124 CREEKBEND BLVD
NACOGDOCHES, TX75965-1780
 Phone: 193-623-4085
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medically Fragile Infants and Children Day Care

261QM3000X
Indicates primary specialty

NPI Profile & details for NACOGDOCHES PEDIATRIC CARE

NPI Number 1518440494
LBN Legal business name NACOGDOCHES PEDIATRIC CARE
Authorized official MISTI HAJJ - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2018
Last updated 08/17/2022 - About 4 years ago
Identifiers
TX Medicaid 4053464
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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