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Organization

DOMINIC ANSARI PEDIATRICS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOMINIC OMAR ANSARI M.D. (MANAGING MEMBER)
(832) 930-1366
Entity
Organization

Contact information

Practice address
2028 E BEN WHITE BLVD, STE 240A, AUSTIN, TX 78741-6966
(832) 930-1366
Mailing address
2028 E BEN WHITE BLVD, STE 240-8801, AUSTIN, TX 78741-6966

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD452657
PA

Other

Enumeration date
07/28/2015
Last updated
08/13/2015
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