Fairmont Childrens Pllc

NPI #1033778170 in Pasadena, Texas

Provider Information

NPI Number: 1033778170
Entity Type: Organization
Organization Name: Fairmont Childrens Pllc
Primary Specialty: Pediatrics
Enumeration Date: Jun 12, 2019
Last Updated: Jun 12, 2019

Practice Location

Address: 4002 BURKE RD STE 200
City: Pasadena
State: Texas
ZIP Code: 77504-3451
Phone: (832) 241-3540

Authorized Official

Name: JILLY VIDYASAGDRAN, MD
Title: AUTHORIZED SIGNER
Phone: (832) 241-3540

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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