Organization
GREAT KIDS PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ROBINSON (OFFICE MANAGER)
(713) 932-6261
Entity
Organization
Contact information
Practice address
915 GESSNER RD, SUITE 350, HOUSTON, TX 77024-2527
(713) 932-6261
Mailing address
PO BOX 3025, MCKINNEY, TX 75070-8181
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065KP
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
03/21/2006
Last updated
07/16/2007
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