Organization
PEDIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN YUDOVICH MD (OWNER PRESIDENT)
(713) 644-1568
Entity
Organization
Contact information
Practice address
4501 GROVEWAY, HOUSTON, TX 77087
(713) 644-1568
(713) 644-1864
Mailing address
4501 GROVEWAY, HOUSTON, TX 77087
(713) 644-1568
(713) 644-1864
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00M924
BCBS
TX
05
—
121131002
—
TX
01
—
121131004
MEDICADE
TX
Enumeration date
12/12/2006
Last updated
02/09/2011
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