Organization
NASA PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDALIA R RIVERA M.D (PRESIDENT)
(281) 464-3780
Entity
Organization
Contact information
Practice address
4014 WOODLAWN AVE, SUITE A, PASADENA, TX 77504
(713) 239-0980
(281) 464-3832
Mailing address
P.O. BOX 890004, HOUSTON, TX 77289
(713) 239-0980
(281) 464-3832
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J5879
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2130981
—
TX
Enumeration date
09/24/2015
Last updated
05/10/2016
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