Provider Demographics
NPI:1740832070
Name:WHISTLESTOP PEDIATRICS, PLLC
Entity type:Organization
Organization Name:WHISTLESTOP PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHNI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP
Authorized Official - Phone:614-946-7674
Mailing Address - Street 1:3911 US HIGHWAY 80 E
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3351
Mailing Address - Country:US
Mailing Address - Phone:614-946-7674
Mailing Address - Fax:
Practice Address - Street 1:3911 US HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3351
Practice Address - Country:US
Practice Address - Phone:614-946-7674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center