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General NPI Number Information
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NPI Number | 1275906356
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PEDIATRIC CARE
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 2379 GUS THOMASSON RD #200
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City | MESQUITE
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State | TX
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Zip | 75150-5302
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Country | US
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Telephone | 585-880-0414
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Fax |
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Provider Business Mailing Address
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Address Line | 6044 E LOVERS LN #8107
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City | DALLAS
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State | TX
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Zip | 75206-4371
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Country | US
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Telephone | 585-880-0414
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEENU M JINDAL
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Credential | D.O.
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Telephone | 585-880-0414
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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 | Q2566
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License Number State | TX
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