Geronimo Village Pediatrics, Pllc

LBN: Geronimo Village Pediatrics, Pllc
Geronimo Village Pediatrics, Pllc is an health care organization with primary practice located at 121 Dennis Dr , Seguin TX 78155-0402. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Geronimo Village Pediatrics, Pllc can be contacted via phone (830) 372-8981, or through Koenig, Jodi Gayle via phone (830) 372-8981.

Contact Information

Primary practice address
121 Dennis Dr Seguin TX 78155-0402
Phone: (830) 372-8981
Fax: (830) 372-8984
Website:
Map and Directions
Authorized official contact:
Name: Koenig, Jodi Gayle CPNP-AC/PC
Phone: (830) 372-8981

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1356800791
LBN Legal business name Geronimo Village Pediatrics, Pllc
DBA Doing business as
Authorized official Koenig, Jodi Gayle CPNP-AC/PC
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2019
Last updated Jun 11th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356800791 NPPES
Texas MEDICAID 339554303

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