| NPI | 1255147120 |
|---|---|
| Doing Business As | PEDIATRICA OF HERITAGE TRACE |
| Entity Type | Organization |
| Authorized Contact | KATHRYN K MANDAL Owner 817-617-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-05 |