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Organization

LITTLE ELM FRISCO CHILDREN'S CLINIC

Active
Parent organization
LITTLE ELM-FRISCO CHILDREN'S CLINIC PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LITTLE ELM-FRISCO CHILDREN'S CLINIC PLLC
Authorized official
DR. PREM P GUPTA MD (PARTNER)
(214) 494-4622
Entity
Organization

Contact information

Practice address
12398 FM 423, SUITE 600, FRISCO, TX 75033-0158
(214) 494-4622
(214) 494-4609
Mailing address
12398 FM 423, SUITE 600, FRISCO, TX 75033-0158
(214) 494-4622
(214) 494-4609

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F7772
TX
208000000X
Pediatrics Physician
F8878
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126877306
TX
05
133070608
TX
05
220282201
TX
05
220282202
TX
05
24778
NM
Enumeration date
02/17/2011
Last updated
01/11/2023
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