Organization Active NPI

Kid Friendly Pediatrics PA

  • Pediatrics Physician
  • Garland, TX
National Provider Identifier
1003356536
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K9430 Issued in TX
Legal business name
KID FRIENDLY PEDIATRICS PA
Practice address
2376 Lavon Dr Ste 130
Garland, TX 75040-9001
Phone
(972) 496-6633
NPI assigned
Mar 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ewa K Stewart, M.D.NPI 1376650648
Title
Physician
Phone
(214) 762-7109

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X K9430 TX Primary

Addresses

Primary practice location

2376 Lavon Dr Ste 130
Garland, TX 75040-9001

Mailing address

2376 Lavon Dr Ste 130
Garland, TX 75040-9001
Phone (972) 496-6633

Other identifiers 1

IdentifierTypeStateIssuer
369997701MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1010823Kid Friendly Pediatrics2376 Lavon Drive Suite 130, Garland, TX 75040Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory

Locations

2376 Lavon Dr
Ste 130
Garland, TX 75040
Phone (972) 496-6633

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20453/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1003356536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 LAVON DR STE 130",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750409001",
            "telephone_number": "972-496-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 LAVON DR STE 130",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750409001",
            "telephone_number": "972-496-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID FRIENDLY PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "EWA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "214-762-7109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K9430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369997701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.