Provider Demographics
NPI:1225401409
Name:LOUETTA PEDIATRICS, PLLC
Entity type:Organization
Organization Name:LOUETTA PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SITTIE
Authorized Official - Middle Name:RAINNI
Authorized Official - Last Name:DIANALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-826-0016
Mailing Address - Street 1:5834 LOUETTA ROAD
Mailing Address - Street 2:SUITE G
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-826-0016
Mailing Address - Fax:281-826-0017
Practice Address - Street 1:5834 LOUETTA ROAD
Practice Address - Street 2:SUITE G
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379
Practice Address - Country:US
Practice Address - Phone:281-826-0016
Practice Address - Fax:281-826-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8322208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty