NPIMap

Organization Active NPI

Abc Pediatric Clinic, P.a.

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1417125642
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ABC PEDIATRIC CLINIC, P.A.
Practice address
13711 Wallisville Rd
Houston, TX 77049-3908
Phone
(713) 455-7777
Fax
(713) 453-7337
NPI assigned
Feb 11, 2008
Last updated
Oct 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Authorized official

Name
Dr. Sogol Pahlavan, M.D.NPI 1154418804
Title
Co-Partner/ Owner
Phone
(832) 746-3105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

13711 Wallisville Rd
Houston, TX 77049-3908

Mailing address

13711 Wallisville Rd
Houston, TX 77049-3908
Phone (713) 455-7777

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1081229Abc Pediatric Clinic PA13711 Wallisville Rd, Houston, TX 77049Certificate of waiverMar 12, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1417125642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13711 WALLISVILLE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770493908",
            "telephone_number": "713-455-7777",
            "fax_number": "713-453-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 WALLISVILLE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770493908",
            "telephone_number": "713-455-7777",
            "fax_number": "713-453-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "SOGOL",
        "authorized_official_title_or_position": "CO-PARTNER/ OWNER",
        "authorized_official_telephone_number": "832-746-3105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.