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Organization
RAINBOW CHILDREN'S CLINIC 3, P.A.
Active
Organization
RAINBOW CHILDREN'S CLINIC 3, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH BERNARDEZ-TAN MD (PEDIATRICIAN/OWNER)
(972) 642-3364
Entity
Organization
Contact information
Practice address
929 W PIONEER PKWY STE A, GRAND PRAIRIE, TX 75051-4726
(972) 641-3364
Mailing address
929 W PIONEER PKWY STE A, GRAND PRAIRIE, TX 75051-4726
(972) 641-3364
(972) 641-3369
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J8913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3163081-01
—
TX
Enumeration date
05/01/2013
Last updated
10/26/2016
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