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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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