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Organization

FRY ROAD PEDIATRICS P.A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IFTHEKAR UNNISSA MD (PRESIDENT)
(281) 578-9766
Entity
Organization

Contact information

Practice address
21372 PROVINCIAL BLVD, KATY, TX 77450-7580
(281) 578-9766
(281) 578-6540
Mailing address
21372 PROVINCIAL BLVD, KATY, TX 77450-7580
(281) 578-9766
(281) 578-6540

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
09/15/2009
Last updated
09/15/2009
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