Provider Demographics
NPI:1962922633
Name:PANDA PEDIATRICS
Entity type:Organization
Organization Name:PANDA PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:LI-PELAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-528-6100
Mailing Address - Street 1:10824 E CRYSTAL FALLS PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-4301
Mailing Address - Country:US
Mailing Address - Phone:512-528-6100
Mailing Address - Fax:512-528-6200
Practice Address - Street 1:10824 E CRYSTAL FALLS PKWY STE 201
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4301
Practice Address - Country:US
Practice Address - Phone:512-528-6100
Practice Address - Fax:512-528-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7798208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty