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Organization
PGVPEDIATRICS, PA
Active
Organization
PGVPEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANURADHA AGRAWAL MD (PRESIDENT)
(214) 823-2552
Entity
Organization
Contact information
Practice address
3310 LIVE OAK ST, SUITE 201, DALLAS, TX 75204-6153
(214) 823-2552
Mailing address
3310 LIVE OAK ST, SUITE 201, DALLAS, TX 75204-6153
(214) 823-2552
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L7295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L7295
MEDICAL LICENSE
TX
Enumeration date
01/16/2007
Last updated
12/05/2011
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