Provider Demographics
NPI:1649980715
Name:GLOBAL PEDIATRICS PLLC
Entity type:Organization
Organization Name:GLOBAL PEDIATRICS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEETA RAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:VANGALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-312-1451
Mailing Address - Street 1:7301 MARQUIS LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3486
Mailing Address - Country:US
Mailing Address - Phone:860-805-3133
Mailing Address - Fax:
Practice Address - Street 1:26875 US HIGHWAY 380 E STE 128
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-4807
Practice Address - Country:US
Practice Address - Phone:469-312-1451
Practice Address - Fax:469-788-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX458166201Medicaid