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General NPI Number Information
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NPI Number | 1306903216
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Entity Type | Organization
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Legal Business Name | KIDS DOC'S PEDIATRIC ASSOCIATES
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 6130 W PARKER RD SUITE 400
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City | PLANO
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State | TX
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Zip | 75093-7901
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Country | US
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Telephone | 972-608-0200
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Fax | 972-608-0617
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Provider Business Mailing Address
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Address Line | 6130 W PARKER RD SUITE 400
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City | PLANO
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State | TX
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Zip | 75093-7901
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Country | US
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Telephone | 972-608-0200
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Fax | 972-608-0617
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. ANNA M GOMEZ
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Credential | MD
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Telephone | 972-608-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | F4005
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | F4402
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License Number State | TX
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Taxonomy #3
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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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