Brazosport Pediatric Clinic, P.a.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BRAZOSPORT PEDIATRIC CLINIC, P.A.

Practice address

54 Flag Lake PLZ
Lake Jackson, TX 77566-6263

Phone

(979) 297-5066

Fax

(979) 297-9096

NPI assigned

Jul 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard A Hardoin, M.D.

Title

President

Phone

(979) 297-5066

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407860737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 FLAG LAKE PLZ",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666263",
            "telephone_number": "979-297-5066",
            "fax_number": "979-297-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 FLAG LAKE PLZ",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666263",
            "telephone_number": "979-297-5066",
            "fax_number": "979-297-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOSPORT PEDIATRIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDOIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-297-5066",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brazosport Psychiatric Clinic (Matthew Brams MD Alice Mao MD)
• Brazosport Radiology PLLC
• Brazosport Regional Physician Services (Brazosport Regional Urgent Care Center)
• Brazosport Rehabilitation & Wellness, LLC

• Pediatrics Physician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.