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General NPI Number Information
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NPI Number | 1124073457
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Entity Type | Organization
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Legal Business Name | NORTH HILLS CHILDRENS CLINIC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 4351 BOOTH CALLOWAY RD STE 210
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-7378
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Country | US
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Telephone | 817-595-3436
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Fax | 817-595-4265
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Provider Business Mailing Address
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Address Line | 4351 BOOTH CALLOWAY RD STE 210
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-7378
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Country | US
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Telephone | 817-595-3436
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Fax | 817-595-4265
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADAPURA S SATYANARAYANA
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Credential | M.D.
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Telephone | 817-595-3436
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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 | F2903
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License Number State | TX
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