| NPI | 1124335765 |
|---|---|
| Doing Business As | STARSIDE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | SARA LYNN GONDOL Owner 469-261-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX M6149) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-02 |