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Organization
RENNER PEDIATRICS AND CHILDREN'S HEALTHCARE, P.A.
Active
Organization
RENNER PEDIATRICS AND CHILDREN'S HEALTHCARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANISA AHMED M.D. (OWNER, DIRECTOR, CEO.)
(972) 231-6564
Entity
Organization
Contact information
Practice address
3409 SPECTRUM BLVD, SUITE 300, RICHARDSON, TX 75082
(972) 231-6564
(972) 231-0360
Mailing address
3409 SPECTRUM BLVD, SUITE 300, RICHARDSON, TX 75082
(972) 231-6564
(972) 231-0360
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
344819301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004PM
BLUECROSS AND BLUESHIELD OF TEXAS
TX
05
—
200613201
—
TX
05
—
200613202
—
TX
05
—
200613203
—
TX
05
—
200613204
—
TX
01
—
8X8990
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/31/2007
Last updated
12/16/2021
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