Organization
FIREFLY PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LEE SEGURA MBA (ADMINISTRATOR)
(512) 940-1027
Entity
Organization
Contact information
Practice address
2148 JACKSON KELLER RD, SAN ANTONIO, TX 78213-2722
(210) 501-0703
(210) 526-0334
Mailing address
2148 JACKSON KELLER RD, SAN ANTONIO, TX 78213-2722
(210) 501-0703
(210) 526-0334
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P3769
TX
2080A0000X
Pediatric Adolescent Medicine Physician
P3769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336517301
—
TX
Enumeration date
03/12/2014
Last updated
12/09/2014
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