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General NPI Number Information
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NPI Number | 1578345500
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Entity Type | Organization
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Legal Business Name | DESOTO PEDIATRICS PA
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 2617 BOLTON BOONE DR STE B
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City | DESOTO
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State | TX
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Zip | 75115-2075
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Country | US
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Telephone | 214-282-6710
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Fax |
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Provider Business Mailing Address
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Address Line | 3213 DREXEL DR
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City | DALLAS
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State | TX
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Zip | 75205-2912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DR. SARAH HOPE ARIYO
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Credential | MD
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Telephone | 214-282-6710
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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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