Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Brazosport Pediatric Clinic, PA

Organization Pediatrics Physician · NPI 1407860737

Brazosport Pediatric Clinic, PA provides Pediatrics Physician services 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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