Healthcare Provider Details

I. General information

NPI: 1225206865
Provider Name (Legal Business Name): ALL CHILDREN'S PEDIATRIC CLINIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 N CONWAY AVE STE D
PALMHURST TX
78573-1532
US

IV. Provider business mailing address

4221 N CONWAY AVE STE D
PALMHURST TX
78573-1532
US

V. Phone/Fax

Practice location:
  • Phone: 956-583-5437
  • Fax: 956-584-6888
Mailing address:
  • Phone: 956-583-5437
  • Fax: 956-584-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FADI MOGHARBEL TORRES
Title or Position: OWNER
Credential: MD
Phone: 956-994-8707