Provider Demographics
NPI:1740807445
Name:PLUM PEDIATRICS PLLC
Entity Type:Organization
Organization Name:PLUM PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHNI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:469-864-7586
Mailing Address - Street 1:270 S COLLINS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4642
Mailing Address - Country:US
Mailing Address - Phone:614-946-7674
Mailing Address - Fax:
Practice Address - Street 1:270 S COLLINS RD STE 300
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4642
Practice Address - Country:US
Practice Address - Phone:469-864-7586
Practice Address - Fax:469-864-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty