Organization
CHILD AND ADOLESCENT CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NURUL ISLAM M.D. (PRESIDENT)
(214) 644-1801
Entity
Organization
Contact information
Practice address
1150 N WATTERS RD # B, SUITE 108, ALLEN, TX 75013-5508
(214) 644-1801
(214) 644-1800
Mailing address
1150 N WATTERS RD # B, SUITE 108, ALLEN, TX 75013-5508
(214) 644-1801
(214) 644-1800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L3690
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199445101
—
TX
01
—
8V2170
BCBS
TX
Enumeration date
03/23/2007
Last updated
06/09/2011
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