| NPI | 1104197417 |
|---|---|
| Former Legal Business Name | PEDIAMED NIGHT CLINIC |
| Entity Type | Organization |
| Authorized Contact | GUILLERMO ACOSTA CEO 915-227-0137 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |