Provider Demographics
NPI:1841423324
Name:METROPLEX PEDIATRIC NIGHT CLINICS PLLC
Entity Type:Organization
Organization Name:METROPLEX PEDIATRIC NIGHT CLINICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-227-0137
Mailing Address - Street 1:6219 FRANKLIN DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7703
Mailing Address - Country:US
Mailing Address - Phone:915-227-0137
Mailing Address - Fax:
Practice Address - Street 1:6219 FRANKLIN DOVE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7703
Practice Address - Country:US
Practice Address - Phone:915-227-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty