Provider Demographics
NPI:1528586054
Name:PEDIATRIC HEALTH SPECIALISTS, INC
Entity Type:Organization
Organization Name:PEDIATRIC HEALTH SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SMITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUTERWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-853-5033
Mailing Address - Street 1:7200 STATE HIGHWAY 161 STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3800
Mailing Address - Country:US
Mailing Address - Phone:972-853-5033
Mailing Address - Fax:973-330-4931
Practice Address - Street 1:7200 STATE HIGHWAY 161 STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3800
Practice Address - Country:US
Practice Address - Phone:972-853-5033
Practice Address - Fax:972-330-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty