Provider Demographics
NPI:1528620150
Name:TCH PEDIATRICS INC
Entity type:Organization
Organization Name:TCH PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TCP - CBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-824-6631
Mailing Address - Street 1:PO BOX 847169
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7169
Mailing Address - Country:US
Mailing Address - Phone:832-824-2999
Mailing Address - Fax:
Practice Address - Street 1:1050 MEADOWS DR STE 307
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4259
Practice Address - Country:US
Practice Address - Phone:512-255-6033
Practice Address - Fax:512-255-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty