LIVINGSTON PEDIATRIC CLINIC PA
NPI 1891848297
Pediatrics in Livingston, TX

Q: What is Livingston Pediatric Clinic PA's NPI number?

The NPI number for Livingston Pediatric Clinic PA is 1891848297. It was assigned to this organization in the NPPES registry on January 19, 2007.

Q: What is Livingston Pediatric Clinic PA's specialty?

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

Active since January 19, 2007

400 OGLETREE DR, LIVINGSTON, TX 77351(936) 328-8812(936) 328-8815 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2024, May 22, 2023, Aug 22, 2020 (3 updates tracked since 2020).

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About Livingston Pediatric Clinic Pa NPPES

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

LIVINGSTON PEDIATRIC CLINIC PA (NPI 1891848297) is a healthcare organization registered as a pediatrics in Livingston, Texas and active in the NPI registry since January 2007. The organization maintains a secondary practice location in Cleveland and lists Marlo Brawner, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1891848297

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameLIVINGSTON PEDIATRIC CLINIC PA

Location Address400 OGLETREE DRLivingston, TX 77351-6783

Mailing Address400 Ogletree DrLivingston, TX 77351-6783 · (936) 328-8812 · Fax (936) 328-8815

Phone(936) 328-8812

Fax(936) 328-8815

Organization SubpartNo

Authorized OfficialMarlo BrawnerMedical Director · (936) 328-8812

Enumeration DateJanuary 19, 2007

Last NPPES UpdateJune 19, 20243 updates tracked since enumeration

NPPES CertifiedJune 19, 2024

✔ NPI 1891848297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

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.

Also ListedPediatrics · Adolescent MedicineTaxonomy 2080A0000X · License J6500 (TX)

400 OGLETREE DR, Livingston, TX 77351

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Secondary Practice Location 1

Location 1203 N College Ave Ste 1001Cleveland, TX 77327-2500 · Phone (281) 592-6000 · Fax (936) 328-8815

Other Identifiers 7

Other0045LZTX · Bcbs Group Number

Medicaid169920907TX

Medicaid169920910TX

Medicaid169920906TX

Medicaid169920909TX

Medicaid169920908TX

Medicaid169920905TX

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Other Providers at the Same Location NPPES 7

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

RENELLA BOULLION APRN, FNP-BC

Nurse Practitioner (Pediatrics)