Provider Demographics
NPI:1063603785
Name:HAPPY KIDS PEDIATRICS, P.C.
Entity type:Organization
Organization Name:HAPPY KIDS PEDIATRICS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:CARRAZCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-223-0091
Mailing Address - Street 1:4802 E RAY RD STE 23
Mailing Address - Street 2:PMB 274
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6410
Mailing Address - Country:US
Mailing Address - Phone:480-223-0291
Mailing Address - Fax:480-223-0295
Practice Address - Street 1:1345 E MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8947
Practice Address - Country:US
Practice Address - Phone:480-223-0291
Practice Address - Fax:480-223-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24255208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty