Organization · Type 2 NPI
Trophy Club Pediatrics PA
Primary Care Clinic/Center · Trophy Club, TX
NPI number
1083034839
Active
Practice location
2811 Mona Vale Rd
Trophy Club, TX 76262-3479
Mailing address
625 Parkview Drive, Suite 102
Trophy Club, TX 76262-3479
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1083034839
Trophy Club Pediatrics PA's National Provider Identifier is 1083034839, issued on Apr 21, 2014. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Trophy Club, TX. The record was last updated on Aug 13, 2014.