Provider Demographics
NPI:1730450669
Name:WEST BELLFORT PEDIATRIC CLINICS, INC.
Entity type:Organization
Organization Name:WEST BELLFORT PEDIATRIC CLINICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IFEYINWA
Authorized Official - Middle Name:PATIENCE
Authorized Official - Last Name:ONWUDIWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:713-981-6002
Mailing Address - Street 1:3631 HANSFORD PL
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4990
Mailing Address - Country:US
Mailing Address - Phone:713-981-6002
Mailing Address - Fax:713-981-7409
Practice Address - Street 1:8527 W BELLFORT ST
Practice Address - Street 2:#B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2265
Practice Address - Country:US
Practice Address - Phone:713-981-6002
Practice Address - Fax:713-981-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1405261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care