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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
Update your record

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