Organization
PEDIDOCS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GOLLEHON (ADMIN ASSISTANT)
(210) 733-4362
Entity
Organization
Contact information
Practice address
9838 WESTOVER HILLS BLVD, SAN ANTONIO, TX 78251
(210) 733-4362
(210) 521-1517
Mailing address
9838 WESTOVER HILLS BLVD, SAN ANTONIO, TX 78251
(210) 733-4362
(210) 521-1517
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182628101
—
TX
Enumeration date
07/26/2006
Last updated
04/28/2021
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