Organization
ANGEL PEDIATRICS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE LOYA (OFFICE MANAGER)
(214) 616-6783
Entity
Organization
Contact information
Practice address
717 S GREENVILLE AVE, SUITE 104, ALLEN, TX 75002-3317
(972) 396-1900
(972) 591-4589
Mailing address
717 S GREENVILLE AVE, SUITE 104, ALLEN, TX 75002-3317
(972) 396-1900
(972) 591-4589
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L8604
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200598501
MEDICAID TPI - GROUP
TX
01
—
200598502
MEDICAID TPI- GROUP HEALTH STEPS
TX
01
—
200601701
MEDICAID TX INDIVIDUAL TPI
TX
01
—
L8604
LICENSE
TX
Enumeration date
12/05/2008
Last updated
06/21/2018
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