Provider Demographics
NPI:1114525532
Name:SPRINGS PEDIATRICS ASSOCIATES PLLC
Entity type:Organization
Organization Name:SPRINGS PEDIATRICS ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OGWARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-353-0006
Mailing Address - Street 1:201 OAK DR S STE 202
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5627
Mailing Address - Country:US
Mailing Address - Phone:979-353-0006
Mailing Address - Fax:346-299-9054
Practice Address - Street 1:201 OAK DR S STE 202
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5627
Practice Address - Country:US
Practice Address - Phone:979-353-0006
Practice Address - Fax:346-299-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4210122Medicaid