Provider Demographics
NPI:1457691248
Name:PEDIATRIC PEOPLE PLLC
Entity type:Organization
Organization Name:PEDIATRIC PEOPLE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:RENATA
Authorized Official - Last Name:LINCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-396-5200
Mailing Address - Street 1:11955 DALLAS PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4293
Mailing Address - Country:US
Mailing Address - Phone:214-396-5200
Mailing Address - Fax:214-504-1796
Practice Address - Street 1:11955 DALLAS PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4293
Practice Address - Country:US
Practice Address - Phone:214-396-5200
Practice Address - Fax:214-504-1796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5745261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center