Active NPI
Bear Creek Pediatric Clinic PA
- Pediatrics Physician
- Houston, TX
National Provider Identifier
1528050150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- E 7433
- Legal business name
- BEAR CREEK PEDIATRIC CLINIC PA
- Practice address
- 4654 Hwy 6 N
Ste 307
Houston, TX 77084-2879 - Phone
- (281) 463-9339
- Fax
- (281) 463-2921
- NPI assigned
- Aug 19, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shobhana Jagat Kamdar, MD
- Title
- President Director Pediatrician
- Phone
- (281) 463-9339
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E 7433 | TX | Primary |
Addresses
Primary practice location
4654 Hwy 6 N
Ste 307
Houston, TX 77084-2879
Mailing address
4654 Hwy 6 N
Ste 307
Houston, TX 77084-2879
Phone (281) 463-9339
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TP9120491901 | Medicaid | TX |
Other names 1
- Shobhana Kamdar, MD
National Provider Directory
National Provider DirectoryLocations
4654 Highway 6 N
Ste 307
Houston, TX 77084
Phone (281) 463-9339
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Houston, TX
- NPI 1942341029
-
- Family Nurse Practitioner
- Spring, TX
- NPI 1841882883
-
- Pediatric Nurse Practitioner
- Houston, TX
- NPI 1053906818
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1528050150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4654 HWY 6 N",
"address_2": "STE 307",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770842879",
"telephone_number": "281-463-9339",
"fax_number": "281-463-2921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4654 HWY 6 N",
"address_2": "STE 307",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770842879",
"telephone_number": "281-463-9339",
"fax_number": "281-463-2921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEAR CREEK PEDIATRIC CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KAMDAR",
"authorized_official_first_name": "SHOBHANA",
"authorized_official_middle_name": "JAGAT",
"authorized_official_title_or_position": "PRESIDENT DIRECTOR PEDIATRICIAN",
"authorized_official_telephone_number": "281-463-9339",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "TX",
"license": "E 7433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TP9120491901",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Shobhana Kamdar, MD",
"code": "5",
"type": "Other Name"
}
]
}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 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.