Provider Demographics
NPI:1467551408
Name:GOOD NIGHT PEDIATRCS
Entity Type:Organization
Organization Name:GOOD NIGHT PEDIATRCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-545-7581
Mailing Address - Street 1:PO BOX 1222
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78294-1222
Mailing Address - Country:US
Mailing Address - Phone:210-545-7581
Mailing Address - Fax:210-545-7041
Practice Address - Street 1:19272 STONE OAK PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3371
Practice Address - Country:US
Practice Address - Phone:210-545-7581
Practice Address - Fax:210-545-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty