Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brazosport Pediatric Clinic, PA

Organization Pediatrics Physician · NPI 1407860737

Brazosport Pediatric Clinic, PA is a Pediatrics Physician in Lake Jackson, Texas. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

54 Flag Lake Plz
Lake Jackson, TX 77566-6263
Phone: (979) 297-5066
Fax: (979) 297-9096
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1407860737
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Hardoin — President · (979) 297-5066
NPI enumeratedJuly 29, 2006
Last updated in NPPESAugust 22, 2020
Mailing address54 Flag Lake Plz, Lake Jackson, TX 77566-6263

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