Organization
FAIRMONT CHILDRENS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILLY VIDYASAGDRAN MD (AUTHORIZED SIGNER)
(832) 241-3540
Entity
Organization
Contact information
Practice address
4002 BURKE RD STE 200, PASADENA, TX 77504-3451
(832) 241-3540
(832) 241-3750
Mailing address
4002 BURKE RD STE 100, PASADENA, TX 77504-3451
(832) 241-3540
(832) 241-3750
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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