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General NPI Number Information
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NPI Number | 1003356536
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Entity Type | Organization
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Legal Business Name | KID FRIENDLY PEDIATRICS PA
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 09/14/2017
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Provider Practice Location Address
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Address Line | 2376 LAVON DR STE 130
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City | GARLAND
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State | TX
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Zip | 75040-9001
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Country | US
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Telephone | 972-496-6633
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Fax |
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Provider Business Mailing Address
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Address Line | 2376 LAVON DR STE 130
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City | GARLAND
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State | TX
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Zip | 75040-9001
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Country | US
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Telephone | 972-496-6633
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. EWA K STEWART
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Credential | M.D.
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Telephone | 214-762-7109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K9430
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License Number State | TX
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