Tiny Tots Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28997 Issued in AZ

Legal business name

TINY TOTS PEDIATRICS LLC

Practice address

2020 Silvercreek Road
Suite 114 Buliding a
Bullhead City, AZ 86442

Phone

(928) 763-7020

Fax

(928) 763-7050

NPI assigned

Jan 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marylou Reyes, M.D.

Title

Owner

Phone

(928) 763-7020

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1649457193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23245",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864393245",
            "telephone_number": "928-763-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SILVERCREEK ROAD",
            "address_2": "SUITE 114 BULIDING A",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-763-7020",
            "fax_number": "928-763-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINY TOTS PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "MARYLOU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-763-7020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "28997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.