Provider Demographics
NPI:1376248401
Name:SEASHELL PEDIATRICS PLLC
Entity Type:Organization
Organization Name:SEASHELL PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-220-8050
Mailing Address - Street 1:6310 NAAMAN FOREST BLVD APT 1229
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5799
Mailing Address - Country:US
Mailing Address - Phone:972-220-8050
Mailing Address - Fax:
Practice Address - Street 1:6310 NAAMAN FOREST BLVD APT 1229
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-5799
Practice Address - Country:US
Practice Address - Phone:972-220-8050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty