Healthcare Provider Details

I. General information

NPI: 1558848259
Provider Name (Legal Business Name): LITTLE ANGELS HEALTHCARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W PLEASANT RUN RD STE 300
LANCASTER TX
75146-1074
US

IV. Provider business mailing address

2700 W PLEASANT RUN RD STE 300
LANCASTER TX
75146-1074
US

V. Phone/Fax

Practice location:
  • Phone: 469-857-5439
  • Fax: 469-857-5444
Mailing address:
  • Phone: 469-857-5439
  • Fax: 469-857-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP133030
License Number StateTX

VIII. Authorized Official

Name: ANGELA NOWELL
Title or Position: NURSE PRACTITIONER
Credential: CPNP
Phone: 469-857-5439