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General NPI Number Information
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NPI Number | 1447598412
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Entity Type | Organization
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Legal Business Name | GOLD PEDIATRICS PA
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 3604 S COOPER ST 120
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City | ARLINGTON
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State | TX
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Zip | 76015-3481
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Country | US
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Telephone | 817-466-8008
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Fax | 817-466-8131
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Provider Business Mailing Address
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Address Line | PO BOX 204181
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City | DALLAS
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State | TX
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Zip | 75320-4181
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Country | US
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Telephone | 817-466-8008
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Fax | 817-466-8131
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHANIE GOLD
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Credential | MD
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Telephone | 817-466-8008
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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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