| NPI | 1346305117 |
|---|---|
| Former Legal Business Name | FORNEY PEDIATRIC & MEDICAL CLINIC, P.A. |
| Entity Type | Organization |
| Authorized Contact | JAYAPRAKASH NARAYAN REDDY President 972-552-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: TX G2825) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX G4198) |
| 207Q00000X Family Medicine (Licence: TX G4198) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2008-11-14 |