Organization
BAYSHORE AREA PEDIATRIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTTO H KIEFFER MD (OWNER/PRESIDENT)
(713) 830-2996
Entity
Organization
Contact information
Practice address
3325 PLAINVIEW ST, SUITE C-9, PASADENA, TX 77504-1989
(713) 830-2996
(713) 830-2998
Mailing address
3325 PLAINVIEW ST, SUITE C-9, PASADENA, TX 77504-1989
(713) 830-2996
(713) 830-2998
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K1505
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092239503
—
TX
Enumeration date
04/01/2014
Last updated
04/01/2014
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