Provider Demographics
NPI:1861914020
Name:DOCTORS OF CHILDREN, LINCOLN PC
Entity type:Organization
Organization Name:DOCTORS OF CHILDREN, LINCOLN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-423-1900
Mailing Address - Street 1:6041 VILLAGE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5774
Mailing Address - Country:US
Mailing Address - Phone:402-423-1900
Mailing Address - Fax:402-423-5991
Practice Address - Street 1:6041 VILLAGE DR STE 150
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5774
Practice Address - Country:US
Practice Address - Phone:402-423-1900
Practice Address - Fax:402-423-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-13Medicaid