Provider Demographics
NPI:1053700286
Name:BOOTIN AND SAVRICK PEDIATRIC ASSOCIATES
Entity type:Organization
Organization Name:BOOTIN AND SAVRICK PEDIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YANOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-9500
Mailing Address - Street 1:10970 SHADOW CREEK PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0121
Mailing Address - Country:US
Mailing Address - Phone:713-795-9500
Mailing Address - Fax:713-795-9590
Practice Address - Street 1:10970 SHADOW CREEK PKWY STE 350
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0121
Practice Address - Country:US
Practice Address - Phone:713-795-9500
Practice Address - Fax:713-795-9590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOOTIN AND SAVRICK PEDIATRIC ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-12
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1929208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110113101Medicaid
TX146820903Medicaid