Provider Demographics
NPI:1508300013
Name:PEDIATRICS & FAMILY KARE PLLC
Entity Type:Organization
Organization Name:PEDIATRICS & FAMILY KARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-254-0390
Mailing Address - Street 1:13229 N 41ST PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6709
Mailing Address - Country:US
Mailing Address - Phone:602-254-0390
Mailing Address - Fax:602-513-8691
Practice Address - Street 1:13229 N 41ST PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6709
Practice Address - Country:US
Practice Address - Phone:602-254-0390
Practice Address - Fax:602-513-8691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33381207Q00000X
AZ27821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty