Provider Demographics
NPI:1255147120
Name:CONTINUUM PEDIATRICS PLLC
Entity type:Organization
Organization Name:CONTINUUM PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MANDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-617-8600
Mailing Address - Street 1:PO BOX 223593
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-3593
Mailing Address - Country:US
Mailing Address - Phone:817-617-8600
Mailing Address - Fax:877-906-1852
Practice Address - Street 1:9509 N BEACH ST STE 102
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6399
Practice Address - Country:US
Practice Address - Phone:817-617-8600
Practice Address - Fax:877-906-1852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty