Provider Demographics
NPI:1376752402
Name:PEDIAPEX HEART CENTER FOR CHILDREN PA
Entity Type:Organization
Organization Name:PEDIAPEX HEART CENTER FOR CHILDREN PA
Other - Org Name:HEART CENTER FOR CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC CARDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:MALAN
Authorized Official - Last Name:KAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-4299
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:B 320
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-4299
Mailing Address - Fax:972-566-4210
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:B 320
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-4299
Practice Address - Fax:972-566-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty