Fairmont Childrens PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

FAIRMONT CHILDRENS PLLC

Practice address

4002 Burke Rd Ste 200
Pasadena, TX 77504-3451

Phone

(832) 241-3540

Fax

(832) 241-3750

NPI assigned

Jun 12, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jilly Vidyasagdran, MD

Title

Authorized Signer

Phone

(832) 241-3540

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jilly Kunjunny Vidyasagaran, M.D.

  • Pediatrics Physician
  • Pasadena, TX
  • NPI 1629034103
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1033778170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 BURKE RD STE 100",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043451",
            "telephone_number": "832-241-3540",
            "fax_number": "832-241-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 BURKE RD STE 200",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775043451",
            "telephone_number": "832-241-3540",
            "fax_number": "832-241-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT CHILDRENS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "VIDYASAGDRAN",
        "authorized_official_first_name": "JILLY",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "832-241-3540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyemasters of Texas, LTD
• Ayo Renee Ezeamama, MSN
• Nnachebe Festus Ezechigbo
• Kristen Ezeude, MD
• Robert Leo Fairchild, MD
• Fairmont Diagnostic and MRI Center LLC
• Fairmont Diagnostic Center and Open MRI
• Fairmont Endoscopy Center
• Fairmont Infusion Center, PLLC
• Fairmont Medical Clinic , PA

• Pediatrics Physician in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.