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General NPI Number Information
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NPI Number | 1205071206
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Entity Type | Organization
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Legal Business Name | ANGEL PEDIATRICS P.A.
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Dates
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Enumeration Date | 12/05/2008
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 717 S GREENVILLE AVE SUITE 104
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City | ALLEN
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State | TX
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Zip | 75002-3317
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Country | US
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Telephone | 972-396-1900
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Fax | 972-591-4589
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Provider Business Mailing Address
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Address Line | 717 S GREENVILLE AVE SUITE 104
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City | ALLEN
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State | TX
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Zip | 75002-3317
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Country | US
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Telephone | 972-396-1900
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Fax | 972-591-4589
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHRISTINE LOYA
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Credential |
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Telephone | 214-616-6783
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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 | L8604
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License Number State | TX
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