Provider Demographics
NPI:1194420877
Name:SUNSHINE PEDIATRIC DAY CENTER, HOUSTON, LLC
Entity type:Organization
Organization Name:SUNSHINE PEDIATRIC DAY CENTER, HOUSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-881-8230
Mailing Address - Street 1:9127 KING ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3607
Mailing Address - Country:US
Mailing Address - Phone:972-882-9498
Mailing Address - Fax:
Practice Address - Street 1:411 LANTERN BEND DR STE 240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2835
Practice Address - Country:US
Practice Address - Phone:954-881-8230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care