Healthcare Provider Details

I. General information

NPI: 1104584721
Provider Name (Legal Business Name): LITTLE STARS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 PRAIRIE DR STE 102
PROSPER TX
75078-3818
US

IV. Provider business mailing address

2120 PRAIRIE DR STE 102
PROSPER TX
75078-3818
US

V. Phone/Fax

Practice location:
  • Phone: 972-544-9455
  • Fax: 972-544-9465
Mailing address:
  • Phone: 972-544-9455
  • 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: DR. PRAGADEESWARI DHANASEKARAN
Title or Position: DIRECTOR
Credential: MD
Phone: 972-544-9455