Healthcare Provider Details

I. General information

NPI: 1740807445
Provider Name (Legal Business Name): PLUM PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 S COLLINS RD STE 300
SUNNYVALE TX
75182-4642
US

IV. Provider business mailing address

270 S COLLINS RD STE 300
SUNNYVALE TX
75182-4642
US

V. Phone/Fax

Practice location:
  • Phone: 469-864-7586
  • Fax: 469-864-7571
Mailing address:
  • Phone: 469-864-7586
  • Fax: 469-864-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROSHNI PATEL
Title or Position: MANAGING MEMBER
Credential: NP
Phone: 469-864-7586