Organization
PEDIATRIC ASSOCIATES OF WYLIE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH A. STROTHER (BILLING MANAGER)
(972) 442-2300
Entity
Organization
Contact information
Practice address
501 WOODBRIDGE PARKWAY, WYLIE, TX 75098
(972) 442-2300
(972) 442-2180
Mailing address
PO BOX 125, WYLIE, TX 75098-0125
(972) 442-2300
(972) 442-2180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066MS
BCBS
TX
05
—
174061501
—
TX
05
—
174061502
—
TX
Enumeration date
03/08/2007
Last updated
02/28/2013
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