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General NPI Number Information
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NPI Number | 1912123985
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Entity Type | Organization
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Legal Business Name | MCKINNEY ABC PEDIATRICS, P.A.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 5333 W. UNIVERSITY DRIVE
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City | MCKINNEY
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State | TX
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Zip | 75071
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Country | US
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Telephone | 972-569-9904
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Fax | 972-569-9943
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Provider Business Mailing Address
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Address Line | PO BOX 2146
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City | MCKINNEY
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State | TX
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Zip | 75070-8165
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Country | US
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Telephone | 972-569-9904
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Fax | 972-569-9943
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JACKIE DONDERO
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Credential |
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Telephone | 972-569-9904
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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 | K2007
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M1578
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License Number State | TX
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