| Pediaq Llc | |
|
10413 Walpole Ln Austin TX 78739-1553 | |
| (310) 713-4847 | |
| Not Available |
| Full Name | Pediaq Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 10413 Walpole Ln, Austin, Texas |
| Authorized Official Name and Position | Fred Johnson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2149843900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediaq Llc 4849 Greenville Ave Ste 1225 Dallas TX 75206-4130 Ph: (214) 984-3900 | Pediaq Llc 10413 Walpole Ln Austin TX 78739-1553 Ph: (310) 713-4847 |
| NPI Number | 1255885745 |
|---|---|
| Provider Enumeration Date | 08/12/2016 |
| Last Update Date | 08/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255885745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | AP81285 (Texas) | Primary |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
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Texas Medclinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9900 S Ih 35, Austin, TX 78748 Phone: 512-291-5577 Fax: 512-291-5576 | |
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