| NPI | 1255292785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI SHAH Executive Manager 682-868-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 2278P1006X Respiratory Therapist, Certified, Pulmonary Function Technologist | |
| 363A00000X Physician Assistant | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-11-24 |
| Last Update Date | 2025-11-24 |