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General NPI Number Information
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NPI Number | 1144728387
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Entity Type | Organization
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Legal Business Name | SAI MVPP PEDIATRICS PLLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 1860 S INDEPENDENCE PRKY SUITE 100
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City | MCKINNEY
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State | TX
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Zip | 75070
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Country | US
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Telephone | 646-510-1431
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Fax |
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Provider Business Mailing Address
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Address Line | 8719 ISAAC ST
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City | PLANO
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State | TX
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Zip | 75024-8507
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Country | US
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Telephone | 646-510-1431
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Fax |
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Authorized Official
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Title or Position | PEDITRICS
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Name | PRASANTHY CHINNAREDDY
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Credential | MD
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Telephone | 646-510-1431
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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 | N0698
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License Number State | TX
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