Provider Demographics
NPI:1851090450
Name:HAPPY & HEALTHY PEDIATRIC PA
Entity Type:Organization
Organization Name:HAPPY & HEALTHY PEDIATRIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-546-5550
Mailing Address - Street 1:12200 PARK CENTRAL DR STE 189
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2116
Mailing Address - Country:US
Mailing Address - Phone:972-546-5550
Mailing Address - Fax:972-546-5551
Practice Address - Street 1:12200 PARK CENTRAL DR STE 189
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2116
Practice Address - Country:US
Practice Address - Phone:972-546-5550
Practice Address - Fax:972-546-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912178856OtherNPI