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Organization
PEDIATRIC CARE FOR KIDS, PA
Active
Organization
PEDIATRIC CARE FOR KIDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WHITE (MANAGER)
(214) 729-5600
Entity
Organization
Contact information
Practice address
11661 PRESTON RD STE 120, DALLAS, TX 75230-6199
(281) 203-5006
Mailing address
1701 RIVER RUN STE 302, FORT WORTH, TX 76107-6547
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
10/06/2021
Last updated
03/03/2022
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