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OLIVE BRANCH PEDIATRICS PLLC NPI 1659808723


NPI Information

NPI: 1659808723
Provider Name: OLIVE BRANCH PEDIATRICS, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 45D0726613

Address:
3105 W 15TH ST STE D
PLANO, TX
ZIP 75075
Phone: (214) 674-9189
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OLIVE BRANCH PEDIATRICS, PLLC is a pediatrics in Plano, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. OLIVE BRANCH PEDIATRICS, PLLC NPI is 1659808723. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3105 W 15TH ST STE D
PLANO, TX
ZIP 75075-700
Phone: (214) 674-9189

The provider's authorized official is Jaeon Abraham .
The authorized official title is Manager and has the following contact phone number (972) 867-2869.

The CLIA number assigned to this NPI record is 45D0726613 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2017 and was last updated on 12/30/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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