Provider Demographics
NPI:1437880671
Name:KIDS GASTROENTEROLOGY
Entity Type:Organization
Organization Name:KIDS GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADAF
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGHIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-733-1033
Mailing Address - Street 1:2715 OSLER DR STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1051
Mailing Address - Country:US
Mailing Address - Phone:469-733-1033
Mailing Address - Fax:469-733-1034
Practice Address - Street 1:2715 OSLER DR STE A
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1051
Practice Address - Country:US
Practice Address - Phone:469-733-1033
Practice Address - Fax:469-733-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty