Provider Demographics
NPI:1053574541
Name:HORIZON CITY PEDIATRICS PA
Entity type:Organization
Organization Name:HORIZON CITY PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-852-4089
Mailing Address - Street 1:14505 HORIZON BLVD
Mailing Address - Street 2:
Mailing Address - City:HORIZON
Mailing Address - State:TX
Mailing Address - Zip Code:79928-8564
Mailing Address - Country:US
Mailing Address - Phone:915-852-4089
Mailing Address - Fax:915-852-2031
Practice Address - Street 1:14505 HORIZON BLVD
Practice Address - Street 2:
Practice Address - City:HORIZON
Practice Address - State:TX
Practice Address - Zip Code:79928-8564
Practice Address - Country:US
Practice Address - Phone:915-852-4089
Practice Address - Fax:915-852-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-06
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty