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 |