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General NPI Number Information
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NPI Number | 1912326802
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Entity Type | Organization
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Legal Business Name | PEDI HEALTH
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 6587 VIRGINIA PKWY
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City | MCKINNEY
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State | TX
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Zip | 75071-5511
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Country | US
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Telephone | 972-548-8382
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Fax | 972-547-9951
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Provider Business Mailing Address
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Address Line | 6587 VIRGINIA PKWY
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City | MCKINNEY
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State | TX
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Zip | 75071-5511
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Country | US
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Telephone | 972-548-8382
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Fax | 972-547-9951
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. CHERYL DENISE ELEY
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Credential | M.D.
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Telephone | 972-548-9382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K2012
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License Number State | TX
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