Provider Demographics
NPI:1679058119
Name:HEALING TOUCH PEDIATRICS PLLC
Entity type:Organization
Organization Name:HEALING TOUCH PEDIATRICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PURNACHANDER
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:SIRIKONDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-321-2841
Mailing Address - Street 1:4907 S COLLINS ST STE 141
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1159
Mailing Address - Country:US
Mailing Address - Phone:817-417-9001
Mailing Address - Fax:817-417-9008
Practice Address - Street 1:4907 S COLLINS ST STE 141
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1159
Practice Address - Country:US
Practice Address - Phone:817-417-9001
Practice Address - Fax:817-417-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAPPLIEDMedicaid