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General NPI Number Information
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NPI Number | 1154730729
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Entity Type | Organization
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Legal Business Name | GROW PEDIATRICS AND ADOLESCENT MEDICINE PLLC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 11/25/2023
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Provider Practice Location Address
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Address Line | 1401 PHILOMENA ST STE 120
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City | AUSTIN
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State | TX
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Zip | 78723-3574
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Country | US
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Telephone | 512-467-7334
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Fax | 512-467-7335
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Provider Business Mailing Address
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Address Line | 1401 PHILOMENA ST STE 120
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City | AUSTIN
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State | TX
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Zip | 78723-3574
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Country | US
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Telephone | 512-467-7334
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Fax | 512-467-7335
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | EMILY ARREAZA
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Credential |
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Telephone | 512-467-7334
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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 |
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License Number State |
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