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Organization
UNIVERSITY PEDIATRIC ASSOCIATION
Active
Organization
UNIVERSITY PEDIATRIC ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA EDWARDS (OFFICE MANAGER)
(979) 696-4440
Entity
Organization
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 340, COLLEGE STATION, TX 77845-8306
(979) 696-4440
(979) 696-6730
Mailing address
PO BOX 3068, BRYAN, TX 77805-3068
(979) 696-4440
(979) 696-6730
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121478501
—
TX
Enumeration date
05/28/2006
Last updated
11/05/2010
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