Healthcare Provider Details

I. General information

NPI: 1013382092
Provider Name (Legal Business Name): HEALTH AND HEALING PEDIATRIC CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W 15TH ST STE 107
PLANO TX
75075-7789
US

IV. Provider business mailing address

3900 W 15TH ST STE 107
PLANO TX
75075-7789
US

V. Phone/Fax

Practice location:
  • Phone: 972-964-7773
  • Fax:
Mailing address:
  • Phone: 972-964-7773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MUHAMMAD MOIN UDDIN
Title or Position: CEO
Credential: M.D.
Phone: 806-640-4872