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Organization

PRIMARY CARE PEDIATRICS,PA

Active
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Organization

PRIMARY CARE PEDIATRICS,PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MINDA LAO TOLEDO M.D. (PRESIDENT)
(409) 729-9200
Entity
Organization

Contact information

Practice address
8333 9TH AVE., SUITE B, PORT ARTHUR, TX 77642
(409) 729-9200
(409) 729-9235
Mailing address
8333 9TH AVE., SUITE B, PORT ARTHUR, TX 77642
(409) 729-9200
(409) 729-9235

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M2487
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178296301
—
TX
05
—
178296302
—
TX
05
—
178297101
—
TX
01
—
M2487
TEXAS LICENSE
TX
Enumeration date
01/09/2007
Last updated
06/24/2008
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