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

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2234311Ab Pediatric Health Clinic Too
12001 Tierra Este Rd # B, El Paso, TX 79938
Certificate of waiverAug 29, 2027

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X
Pediatric Adolescent Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
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

IdentifierTypeStateIssuer
P5938OtherTXTEXAS LICENSE

Other providers in El Paso, TX

All providers in El Paso, TX · Pediatric Adolescent Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.