MEDICARE: WEE TOTS PEDIATRICS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1740494160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEE TOTS PEDIATRICS, P.A.

Provider Business Mailing Address
First Line	:	4201 INTERWAY PLACE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-0000
Country	:	US
Telephone Number	:	817-652-9192
Fax Number	:	817-652-3011

Provider Business Practice Location Address
First Line	:	4201 INTERWAY PLACE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-0000
Country	:	US
Telephone Number	:	817-652-9192
Fax Number	:	817-652-3011

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JASMIN G. MARTINEZ
Credential	:
Telephone Number	:	817-652-9192

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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