Livingston Pediatric Clinic Pa

LBN: Livingston Pediatric Clinic Pa
Livingston Pediatric Clinic Pa is an health care organization with primary practice located at 400 Ogletree Dr , Livingston TX 77351-6783. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is the primary health care specialty. Livingston Pediatric Clinic Pa can be contacted via phone (936) 328-8812, or through Brawner, Marlo via phone (936) 328-8812.

Contact Information

Primary practice address
400 Ogletree Dr Livingston TX 77351-6783
Phone: (936) 328-8812
Fax: (936) 328-8815
Website:
Map and Directions
Authorized official contact:
Name: Brawner, Marlo Doctor of Medicine (MD)
Phone: (936) 328-8812

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X J6500 Texas

Profile Details

NPI number 1891848297
LBN Legal business name Livingston Pediatric Clinic Pa
DBA Doing business as
Authorized official Brawner, Marlo Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2007
Last updated Jun 19th, 2024 - about last year

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 1891848297 NPPES
Texas Other 0045LZ BCBS GROUP NUMBER
Texas MEDICAID 169920907 BCBS GROUP NUMBER
Texas MEDICAID 169920910 BCBS GROUP NUMBER
Texas MEDICAID 169920906 BCBS GROUP NUMBER
Texas MEDICAID 169920909 BCBS GROUP NUMBER
Texas MEDICAID 169920908 BCBS GROUP NUMBER
Texas MEDICAID 169920905 BCBS GROUP NUMBER

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