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General NPI Number Information
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NPI Number | 1891136990
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Entity Type | Organization
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Legal Business Name | PRESTON WOOD PEDIATRICS, LLC
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 318 W BELT LINE RD SUITE 303
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City | CEDAR HILL
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State | TX
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Zip | 75104-1104
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Country | US
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Telephone | 972-349-1313
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Fax | 888-371-6987
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Provider Business Mailing Address
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Address Line | 318 W BELT LINE RD SUITE 303
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City | CEDAR HILL
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State | TX
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Zip | 75104-1104
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Country | US
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Telephone | 972-349-1313
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Fax | 888-371-6987
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WURNEICE W CUINGTON
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Credential |
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Telephone | 972-349-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 015866
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License Number State | TX
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