| Superior Pediatrics | |
|
3105 Ira E Woods Ave Grapevine TX 76051-3891 | |
| (817) 416-5372 | |
| (817) 416-5372 |
| Full Name | Superior Pediatrics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3105 Ira E Woods Ave, Grapevine, Texas |
| Authorized Official Name and Position | Remigio Gungon Capati (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8174165372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Superior Pediatrics 1611 Regal Oaks Dr Southlake TX 76092-3443 Ph: (817) 416-5372 | Superior Pediatrics 3105 Ira E Woods Ave Grapevine TX 76051-3891 Ph: (817) 416-5372 |
| NPI Number | 1881811149 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 07/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881811149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | J5220 (Texas) | Primary |
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