Ab Pediatric Health Clinic Too PLLC
Organization Active NPI Pediatric Adolescent Medicine Physician · El Paso, TX
NPI 1073265104 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1073265104
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- Legal business name
- AB PEDIATRIC HEALTH CLINIC TOO PLLC
- Practice address
- 12001 Tierra Este Rd
El Paso, TX 79938-4573 - Phone
- (915) 295-0455
- Fax
- (915) 706-4028
- NPI assigned
- Jan 20, 2022
- Organization subpart
- No
Authorized official
- Name
- Andres D Boadella, MD
- Title
- Owner
- Phone
- (915) 577-0455
Practitioners 1
-
Andres Domingo Boadella, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2234311 | Ab Pediatric Health Clinic Too | Certificate of waiver | Aug 29, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | |||
| Pediatric Adolescent Medicine Physician |
2080A0000X | Yes |
Addresses
Primary practice location
12001 Tierra Este Rd
El Paso, TX 79938-4573
Mailing address
1500 Finsterwald PL
El Paso, TX 79936-6011
Phone (817) 209-4946
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P5938 | Other | TX | TEXAS LICENSE |
Other providers in El Paso, TX
- A Traveling Dietitian
- A&I Medical Group
- Aa Relax Dental Care P.L.L.C.
- Srinivasa Reddy Aaluri
- Ab Pediatric Health Clinic PLLC
- ABA Comprehensive Services, LLC
- Carol N Abalihi
- Nnaemeka Abalihi
- Amarachi Abanobi
- Jose Walterio Abarca
All providers in El Paso, TX · Pediatric Adolescent Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.