Healthcare Provider Details

I. General information

NPI: 1063102762
Provider Name (Legal Business Name): HIMA JYOTHI PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11547 INDEPENDENCE PKWY # 500
FRISCO TX
75035-4677
US

IV. Provider business mailing address

11547 INDEPENDENCE PKWY # 500
FRISCO TX
75035-4677
US

V. Phone/Fax

Practice location:
  • Phone: 972-597-0413
  • Fax:
Mailing address:
  • Phone: 972-597-0413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: HIMA BINDU JYOTHI
Title or Position: PEDIATRICIAN
Credential: MD
Phone: 361-522-0992