Healthcare Provider Details

I. General information

NPI: 1588038277
Provider Name (Legal Business Name): HEALTHY ANGELS PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 ROGERS RD # 1038
SAN ANTONIO TX
78251-4586
US

IV. Provider business mailing address

1818 ROGERS RD # 1038
SAN ANTONIO TX
78251-4586
US

V. Phone/Fax

Practice location:
  • Phone: 631-671-2806
  • Fax: 210-526-0334
Mailing address:
  • Phone: 631-671-2806
  • Fax: 210-526-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN4673
License Number StateTX

VIII. Authorized Official

Name: DR. PETER D PIRRAGLIA
Title or Position: OWNER
Credential: MD
Phone: 631-671-2806