Provider Demographics
NPI:1245416106
Name:GENERATION NEXT PEDIATRICS PA
Entity Type:Organization
Organization Name:GENERATION NEXT PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-801-1416
Mailing Address - Street 1:2131 N COLLINS ST # 433-758
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-2849
Mailing Address - Country:US
Mailing Address - Phone:817-801-1416
Mailing Address - Fax:
Practice Address - Street 1:2131 N COLLINS ST # 433-758
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-2849
Practice Address - Country:US
Practice Address - Phone:817-801-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0008208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1174614952OtherPROVIDER NPI