1. Home
  2. Directory
  3. Texas
  4. Port Arthur
  5. Pediatrics
  6. NPI Profile

PRIMARY CARE PEDIATRICS,PA
NPI 1417006735
Pediatrics in Port Arthur, TX

Active since January 09, 2007CLIA 45D1059554 · Waiver
8333 9TH AVE., SUITE B, PORT ARTHUR, TX 77642(409) 729-9200(409) 729-9235 Get Directions Write a Review

NPPES record last updated: June 24, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Primary Care Pediatrics,pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CARE PEDIATRICS,PA (NPI 1417006735) is a healthcare organization registered as a pediatrics in Port Arthur, Texas and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through October 2, 2026 and lists Minda Lao Toledo, President, as its authorized official.

NPPES Registry Identity

NPI1417006735
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePRIMARY CARE PEDIATRICS,PA
Location Address8333 9TH AVE., SUITE BPort Arthur, TX 77642
Mailing Address8333 9th Ave., Suite BPort Arthur, TX 77642 · (409) 729-9200 · Fax (409) 729-9235
Phone(409) 729-9200
Fax(409) 729-9235
Organization SubpartNo
Authorized OfficialMinda Lao ToledoPresident · (409) 729-9200
Enumeration DateJanuary 9, 2007
Last NPPES UpdateJune 24, 2008
✔ NPI 1417006735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · M2487
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
8333 9TH AVE., Port Arthur, TX 77642
Open in Google Maps ↗

Other Identifiers 6

OtherM2487TX · Texas License
Medicare UPINI47897TX
Medicaid178297101TX
Medicare ID-Type Unspecified00953ZTX
Medicaid178296301TX
Medicaid178296302TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1059554

Primary Care Pediatrics PA · Port Arthur, TX
Active · expires Oct 2, 2026
CLIA Number45D1059554
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateOctober 2, 2026
Laboratory DirectorMinda L. Toledo, MD
Laboratory Phone(409) 729-9200
Laboratory LocationPrimary Care Pediatrics PA8333 9th Avenue Suite B, Port Arthur, TX 77642
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

9TH AVENUE PHYSICAL THERAPY, PLLC
Clinic/Center (Physical Therapy)
8333 9TH AVE., SUITE D
PORT ARTHUR, TX 77642
Jefferson County (409) 729-8111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary Care Pediatrics,pa's NPI number?

The NPI number for Primary Care Pediatrics,pa is 1417006735. It was assigned to this organization in the NPPES registry on January 9, 2007.

Where is Primary Care Pediatrics,pa located?

Primary Care Pediatrics,pa is located at 8333 9th Ave. Suite B, Port Arthur, TX 77642. The listed phone number is (409) 729-9200.

What is Primary Care Pediatrics,pa's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Primary Care Pediatrics,pa hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D1059554) is associated with this NPI, valid through October 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Primary Care Pediatrics,pa was last updated on June 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.