Organization Name: | DEMING PEDIATRICS PLLC |
NPI Number: | 1285955872 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA M DEMING (OWNER) |
Mailing Address: | 1300 N Virginia St Suite 111 Port Lavaca |
State: | TX US |
Postal Code: | 779792509 |
Phone Number: | 3615536844 |
Fax Number: | 3615537314 |
NPI Enumeration Date: | 06/17/2010 |
NPI Last Update Date: | 06/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 587712 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |