Nacogdoches Pediatric Extended Care

LBN: Nacogdoches Pediatric Care
Nacogdoches Pediatric Extended Care is an health care organization with primary practice located at 124 Creekbend Blvd , Nacogdoches TX 75965-1780. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medically Fragile Infants and Children Day Care, which is considered as the primary health care specialty. Nacogdoches Pediatric Care can be contacted via phone (193) 623-4085, or through Hajj, Misti via phone (318) 348-5945.

Contact Information

Primary practice address
124 Creekbend Blvd Nacogdoches TX 75965-1780
Phone: (193) 623-4085
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hajj, Misti
Phone: (318) 348-5945

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medically Fragile Infants and Children Day Care 261QM3000X

Profile Details

NPI number 1518440494
LBN Legal business name Nacogdoches Pediatric Care
DBA Doing business as Nacogdoches Pediatric Extended Care
Authorized official Hajj, Misti
Entity Organization
Organization subpart 1 No
Enumeration date Sep 7th, 2018
Last updated Aug 17th, 2022 - about 2 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 1518440494 NPPES
Texas MEDICAID 4053464

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