Organization Name: | HEALTHY FUTURES PEDIATRICS OF HUTTO, LLC |
NPI Number: | 1952670465 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IRENE GONZALEZ (OWNER) |
Mailing Address: | 210 Hwy 79 Ste. 104 Hutto |
State: | TX US |
Postal Code: | 786344533 |
Phone Number: | 5123680200 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2011 |
NPI Last Update Date: | 12/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 709535 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |