Provider Demographics
NPI:1376732339
Name:KIDS HEALTHCARE, INC
Entity Type:Organization
Organization Name:KIDS HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:TURNER
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:972-932-1319
Mailing Address - Street 1:1011 W GROVE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1882
Mailing Address - Country:US
Mailing Address - Phone:972-932-1319
Mailing Address - Fax:972-932-1388
Practice Address - Street 1:1011 W GROVE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1882
Practice Address - Country:US
Practice Address - Phone:972-932-1319
Practice Address - Fax:972-932-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty