Excellent Life Pediatrics LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXCELLENT LIFE PEDIATRICS LLC

Practice address

10701 Corporate Dr Ste 232
Stafford, TX 77477-4050

Phone

(281) 802-8927

NPI assigned

Oct 1, 2024

Organization subpart

No

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

Authorized official

Name

Theclar Omeh

Title

Owner

Phone

(281) 802-8927

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1073331724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 232",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774050",
            "telephone_number": "281-802-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 232",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774050",
            "telephone_number": "281-802-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT LIFE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "OMEH",
        "authorized_official_first_name": "THECLAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-802-8927"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.