Individual
KAY ALINE LY PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1935 MEDICAL DISTRICT DR, PEDIATRIC SURGERY DEPARTMENT, DALLAS, TX 75235-7701
(214) 456-6040
Mailing address
1935 MEDICAL DISTRICT DR, PEDIATRIC SURGERY DEPARTMENT, DALLAS, TX 75235-7701
(214) 456-6040
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
688052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190192801
—
TX
Enumeration date
10/30/2007
Last updated
10/16/2008
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