Healthcare Provider Details

I. General information

NPI: 1982278479
Provider Name (Legal Business Name): LUVNCARE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4909 GOLDEN TRIANGLE BLVD STE 231
FORT WORTH TX
76244-4480
US

IV. Provider business mailing address

706 MANCHESTER CT
SOUTHLAKE TX
76092-8930
US

V. Phone/Fax

Practice location:
  • Phone: 682-297-5437
  • Fax: 682-228-6447
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANSHU DALELA
Title or Position: PHYSICIAN
Credential: MD
Phone: 682-297-5437