Basic Information
| Provider Information | |||||||||
| NPI: | 1053552281 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNSHINE PEDIATRICS P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5428 S JACKSON RD | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785396672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566825515 | ||||||||
| FaxNumber: | 9566825554 | ||||||||
| Practice Location | |||||||||
| Address1: | 5428 SOUTH JACKSON RD. | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566825515 | ||||||||
| FaxNumber: | 9566825554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2009 | ||||||||
| LastUpdateDate: | 03/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | HUQ | ||||||||
| AuthorizedOfficialFirstName: | MAHFUZUL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9566825515 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | L8738 | TX | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 208000000X | L8738 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.