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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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