Healthcare Provider Details
I. General information
NPI: 1407323751
Provider Name (Legal Business Name): HEALTH FOR KIDS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2018
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2501 SCRIPTURE ST STE 101
DENTON TX
76201-2314
US
IV. Provider business mailing address
PO BOX 80091
KELLER TX
76244-2901
US
V. Phone/Fax
- Phone: 502-380-7831
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABDIER
DELGADO GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 502-380-7831