Healthcare Provider Details
I. General information
NPI: 1205626819
Provider Name (Legal Business Name): SUNSHINE PEDIATRIC DAY CENTER, ROWLETT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6617 HERITAGE PKWY
ROCKWALL TX
75087-8750
US
IV. Provider business mailing address
13355 NOEL RD STE 1310
DALLAS TX
75240-6623
US
V. Phone/Fax
- Phone: 972-453-1710
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM3000X |
| Taxonomy | Medically Fragile Infants and Children Day Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
MAYMON
Title or Position: FOUNDER/CEO
Credential:
Phone: 954-881-8230