Provider Demographics
NPI:1962709394
Name:WELL CHILD PEDIATRICS, PLLC
Entity type:Organization
Organization Name:WELL CHILD PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILAJA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:KANCHERLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-655-8061
Mailing Address - Street 1:22703 SHANNON FALLS CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2259
Mailing Address - Country:US
Mailing Address - Phone:919-655-8061
Mailing Address - Fax:
Practice Address - Street 1:26440 FM 1093 RD
Practice Address - Street 2:SUITE 350
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7201
Practice Address - Country:US
Practice Address - Phone:281-333-1062
Practice Address - Fax:281-335-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty