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Organization
PRIME PEDIATRICS
Active
Organization
PRIME PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAN BABU RAYALA M.D. (PEDIATRICIAN)
(956) 271-8050
Entity
Organization
Contact information
Practice address
2005 E GRIFFIN PKWY, 193, MISSION, TX 78572-3222
(956) 271-8050
Mailing address
2005 E GRIFFIN PKWY, 193, MISSION, TX 78572-3222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
Q6091
TX
261QP2300X
Primary Care Clinic/Center
Q6091
TX
Other
Enumeration date
01/13/2016
Last updated
03/17/2016
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